Patient forms

Hair History Form

Fill this form out and bring it to your first visit.

Hair History Form

Schedule an appointment

“I would recommend Dr. Simon to ANYONE looking for treatment for hair loss. What's the old saying, you get what you pay for. His thoughtful approach and attention to detail was something you don't see in most doctors. I am absolutely thrilled that I have a youthful head of hair again.”

Liam C.

Vegas Valley Hair Restoration Vegas Valley Hair Restoration Vegas Valley Hair Restoration logo Hair History Form Fill this form out and bring it to your first visit. Hair History Form
 (702) 472–9892