Follow-Up Dr. Stoller - Virtual Follow Up Name* First Last Gender (assigned at birth)*- Select -MaleFemalePlease enter your birthday* Did you have surgery?*- Select -Yes, I had FUEYes, I had FUTNo, I did not have surgeryIf you had surgery, what month and year? Are you using any of the following?* Lower Level Laser Light Therapy Finasteride PRP Minoxidil None of the above Do you have any questions or concerns you would like to address with Dr. Stoller?Hair Loss Image UploadPlease attach five photos: top, front, right, crown and back of your head. Your face should take up 75% of the photo.Example - Top of Head Top of Head Image UploadMax. file size: 50 MB.Example - Front of Head Front of Head Image UploadMax. file size: 50 MB.Example - Right Side of Head Right Side of Head Image UploadMax. file size: 50 MB.Example - Crown of Head Crown of Head Image UploadMax. file size: 50 MB.Example - Back of HeadBack of Head Image UploadMax. file size: 50 MB.
