Your free consultation

Request your free consultation

Fill in the form and send your request via WhatsApp or email. We will get back to you quickly.

Name *

Phone number *

Email address *

Age *

Date of birth *

Preferred period for the treatment

Treatment *

Which zones would you like to have treated?

Click the zones on the image. You will immediately see the estimated grafts and formula.

I would like to send photos of my hairAfter sending, you can add your photos directly in the WhatsApp chat.

Privacy and consent

Your data — including medical data and any photos — is used solely to assess your request and prepare your consultation. It is treated confidentially, not shared with third parties and not kept longer than necessary. Photos you share via WhatsApp are covered by WhatsApp's privacy policy. You can have your data deleted at any time via info@hairfiks.com.

I agree to the processing of my data, medical data and photos as described above. *

Your message (optional)

Declaration and signature

I declare that I have completed this medical form truthfully, correctly and completely to the best of my knowledge. I hereby sign as read and approved. *

Sign here *

On sending, a PDF medical form with all your details and signature is created.

How would you like to contact us?

Choose WhatsApp for a quick reply or send us an email.

WhatsApp

+32 499 50 50 90Continue on WhatsApp

E-mail

info@hairfiks.comSend an email

What can you expect?

A free assessment and honest advice.

Hair, scalp or beard analysis
Clear result and recovery guidance
Transparent plan and price
No obligation