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Registration Form

Please provide us with the following information so that we may contact you to set up a consultation with Prof. Song Jianxing . If you live outside Shanghai (including citys of SuZhou, WuXi,NanJing and HangZhou) and are unable to come in for an evaluation for a surgical transplant, you can use our photo consultation form.

* First Name:
* Last Name:
* E-mail:
* Daytime Phone:   i.e. 0086-21-58764134
* Gender Male Female      
  Prof. Song Jianxing, M.D.
Bestway International Plastic and Cosmetic Surgery
120 Fenyang Road,
Xuhiui District, Shanghai, China
 
* How did you hear about us? ( Please select one at least! )      
Hair Restoration Network Hair Loss Help Hair Transplantation
Network Tongji University Google
Friends Family Follicular Unite
Forum  
 
* What do you need?
* Required fields


If you have any questions about the Shanghai Center for Hair Transplant, or about hair trans-plants, follicular unit grafts, or anything else, please don't hesitate to contact us.

Shanghai Center for Hair Transplant,
Bestway International Plastic and Cosmetic Surgery
120 Fenyang Road, Xuhui district , Shanghai, China.
: (86)21 5876 4134
Email: info@eastplasticsurgery.com

Hair Transplant
Follicular Unit Micrografting
Follicular Unit Micrografting
Registration Form

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