Contact Hair Transplant Center Tulsa Oklahoma

Affordable Hair Transplants from the Hair Transplant Center Inc.

Contact Hair Transplant Center

Please fill out this form to learn more about treating your hair loss and your options with hair transplants. You can also send us your hair loss photos which will give us a better understanding of your hair loss and an approximate idea of your hair replacement needs.*

Your information and photos become a part of your medical file at HTC and we will not sell, trade, lease or give that information to anyone - ever. If you have more questions, comments or helpful information to give us after you have completed this form, please do not hesitate to contact us again.

Please send photos to:

Hair Transplant Center, Inc. | 5520 South Lewis Avenue | Tulsa, Oklahoma 74105
Business hours: Monday - Friday, 8 am to 6 pm, Central Time

Tell Me More About How I Can Qualify to Receive My Travel Allowance

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Your Name*

E-Mail Address**

Please double check your email address:

Street Address

Apt. or Suite #

City

State or Providence

Country

Zip Code

Home Phone*

Valid Home Telephone # Necessary

Work Phone

Age

Any family history of baldness or thinning hair? Yes
No
I don’t know

Did baldness or thinning hair come about rather suddenly? Yes
No

What is your time frame to proceed?

I’m ready to proceed now.
I hope to do something soon.
I’m evaluating various options.
I’m just curious.

Will you require financing assistance? Yes
No
I don’t know

Special instructions, questions, and / or comments:

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