Patient forms

Hair History Form

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

Hair History Form

Schedule an appointment

“Facing hair loss as a woman is agonizing. I was embarrassed and didn't realize there was help out there. I now can go out feeling confident in my appearance. Thank you Dr. Simon. Thank you.”

Sandra L.

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