Hair Replacement, Hair Restoration and Hair Extensions from Hair Institute in Lexington, Kentucky      


Hair Institute Incorporated
1795 Alysheba Way
Suite 7101
Lexington, Kentucky 40509

859-263-9811
859-263-3890
Email: hairinst@aol.com

 


At Hair Institute we are dedicated to client service and satisfaction, please help us serve you better by providing some of the following information: 


Online Consultation E-mail Form

Name  

Address

City 

State  

 Zip

 Email Address

My scalp is: dry,   normal or  oily?      My hair is: dry   normal  oily

My hair is just beginning to thin out, Yes   No 

I have been losing my hair for: Less than a year 1-3 years  3-5 years  More than 5 years

The following diagram best describes my current hair loss: (choose one)             

Hair Loss Diagram A or B

Hair Loss Diagram C or D  

Hair Loss Diagram G or H

Diagram of Hair loss...K or L

I have tried: hair replacement rogaine propecia topical solutions

I currently use the following: 
 
(Please describe the hair loss method you're currently using, if any.)

I am looking for a better hair loss solution: (than the one I'm using now) Yes 

The most important solution for me would include:
 
Quality Products Private & Efficient Services Friendly and Professional Stylists   Price   All of these

I am ONLY interested in a solution that is undetectable Yes


I have NEVER found a product, service or company that can or will offer me:
 

Additional Comments:

( Click here when your information input has been completed )

( Click here to clear all of the fields on this form.)

 


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