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ON-LINE CONSULTATION

Please fill in the following form to receive a personal consultation. Give a detailed description of your own hair loss or thinning condition and feel free to ask any questions you might have.

CONSULTATION ON HAIR TRANSPLANT SURGERY

Please fill in all the fields marked with an asterisk (*) to obtain a CONSULTATION ON HAIR TRANSPLANT SURGERY from HSD.
If you prefer to receive a reply by post or fax, state so and give your postal address or fax number.

* Name/surname
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* Authorisation to process data

In compliance with 2004 legislation governing the 'Privacy of Personal Data’ (previously Law 675/96 of the 31.12.96), I hereby authorise HSD - Hair Surgery Division to use the data supplied by me for the purpose of providing commercial proposals and information. I understand that I have the right to delete, modify, and update the said data as permitted by Article 13 of the said legislation.
HSD: hair transplant surgery

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