Home
Shop Online
About Us
Services
Photo Gallery
Video Gallery
News
Introduction
Free Consultations
Contact Us

Personal Consultation

HomeFree Consultations

We can determine the hair loss solution that is right for you.
For a personalized service, call an associate at 1-800-533-0866.
For a virtual consultation, fill out the form below and one of our associates will contact you.

Last Name:

First Name:

Address:

City:

State:

Zip:

Phone:

Alternate Phone:

Email:

Occupation:

Age Range:

Martial Status :

Birth date:

How did you hear about Another Look Hair Institute?:

Have you received our brochure and product information? If so, how long ago? :

Your hair loss was noticed at what age? :

Does baldness run in your family? If so, who in your family has hair loss? :

Are you aware of any scalp disorders you may have? :

Are you currently taking any medications? If so, please explain. :

What attracted you to Another Look Hair Institute? :

What are your concerns about restoring your hair? :

What activities do you participate in? :

Basketball

Baseball

Football

Water Sports

Tennis

Golf

Weight Lifting

Running

Other, please specify:

Biking

Soccer

Please indicate how your hair loss affects your lifestyle:

Meeting New People

At the Beach

Self-esteem

At work

When others comment

In your social life

Overall appearance

To wear a hat

On a windy day

Seeing old friends

Getting dressed-up

When playing sports

What have you tried? :

Shampoo

Hair Piece

Hair Transplants

Rogain-Minoxidal

Propecia

Nothing

Other, please specify:

Please indicate which number best describes your hair loss from the diagrams below:

Once you hit submit, your information will be sent to us and an associate will be in touch.

Add new comment

Choose Your Diagram Here

1020 East Saginaw
Lansing, Michigan 48906
1-800-533-0866

Hours of Operation

Monday closed
Tuesday 8am - 5pm
Wednesday 8am - 7pm
Thursday 8am - 5pm
Friday 7am - 5pm
Available by Appointment

Contact info

1.800.533.0866

laurie@anotherlookonline.com

1020 East Saginaw Lansing, MI 48906

Get in touch:

Contact

name: *

e-mail: *

description: *