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Alopecia Areata
Alopecia
Areata
Alopecia Totalis
Alopecia
Totalis
Alopecia Universalis
Alopecia
Universalis
Androgenetic Alopecia (Male)
Male pattern
baldness
Androgenetic Alopecia (Female)
Female pattern
baldness
Diffuse Alopecia
Diffuse
Alopecia
Tricotillomania
Trichotillo
mania
Scaring Alopecia
Scaring
Alopecia
Chemotherapy and Hair loss
Chemotherapy
& Hair loss
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Before Treatment
After Treatment
more results...
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Chemotherapy & hair loss
Sirodhara treatment
Poor hair growth in children
Eyebrow loss
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USA
UK
Surat
Ahmedabad
Mumbai
Haryana
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Hairloss (any type)
Hairloss due to anemia
Hairloss due to color and dye
Premature graying of hair
Pattern Baldness
Dandruff
Lusterless, dull hair
Menopause and Hairloss
Pediculosis
Ultimate haircare tips
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Home » detail

ONLINE CONSULTATION FORM

  * Field are mandatory !

1.

General information :

 
* Name
* Age
* Sex Male Female
* Address:
(Type the correct address where you want your medicine to be sent)
* Phone No
* E-mail
 
2.

Discription of your problem in your words

 

 
3.

Which type of alopecia do you suffer ?

 

(Click here to see the photographs of different type of alopecia. )

Alopecia areata,
Alopecia totalis
Alopecia universalis
Male/Female pattern baldness
General hailoss
Others
Diffuse alopecia
Tricotillomania
Scaring alopecia
Chemotherapy and hairloss
Hairloss due to hair dye, hair colour, perming, straightening ect.
 
4.

Do you suffer any other medical conditions at present like...

 
thyroid
diabetes
hypertension
depression, stress
Irregular menstruation cycle
constipation
acidity
others
 
5.

Visual Examination:

 
Is the hair loss all over scalp ?
Yes
No
 
Is the Hair loss limited to the top of the
scalp, temples and occipital region ?
Yes
No
Describe..    
 

Is there dandruff, fungus, lice, nits
present on the scalp ?

Yes
No
   
 
6.

Hair related lab reports:             (skip this if you have not done any lab reports)

 
Thyroid Normal Hyper Hypo
  Estrogen Progesterone Level Normal Imbalance
  DHT level
  Iron concentration Normal Anemia
 
7.

Quality of your hair

 
Normal Rough Silky
Gray Dull Brittle
Dry Straight Thick
Brown Oily Curly
Black Blond Wavy
Uncombable
 
8.

Photographs of the affected area with 2-3 different views

 

Attach photographs here:

1.

2.

3.

(the File size should not be more than 300 KB, File format should be .jpg, .gif, .tif, .png, .pcx or .bmp only)

If you are not able to send the picture using this form
please send it with seperate email to info@alopeciacure.com

If you don't have any photograph, please see the page "what is alopecia" and mention picture no. of what is alopecia match with your problem.

Picture No.

Picture No.

Picture No.

 
9.
Payment Details * Want to pay now ? Click here
 


Give the payment details
(If you have already paid)
(Order ID if paid by Credit Card / T.T. details / Cheque Number / Cheque Date / Bank name / Bank Branch etc.)

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Dr. Rohit's schedule

Dr Rohit has came back from USA / UK and he is now available at Alopecia treatment center, Surat.

Mumbai: (2nd and 4th Sunday) Crresshhha Polyclinc, Devi Ekveera A Building (Basement), Nr. HDFC, 79, Old Nagardas Road, Andheri (E), Mumbai - 400 069. Tel.: (022) 66989770
March - 14,28,
April - 11,25,

 

Ahmedabad Dr Sunil shah [M.D.], 14/10 Vir-vijay Society, Near Sanghavi High School, Naranpura, Ahmedabad. Ph.:079-27410607 (first Sunday of the month)
April - 4

 
Success Stories

Vidit shah [USA]
A case of extensive alopecia areata successfully treated
Read more...

Holly McGuffin [USA]
19 year young girl got her beautiful hair back
Read more...

Fluer Hamill [NEW ZEALAND]
is now happy to have such a beautiful hair..
Read more...

Hema [INDIA]
17 years young girl looks more confident now
Read more...

 
 

 

Interested in treatment ?

 

 
Alopecia Treatment Center
 
  Contact Information
   
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Permanant Address :

Alopecia Treatment Center

(Formerly known as Herbal Treatment Center)
Dr. Rohit Shah

1/3839 Nani Desai Pole, Nr. Maltiben's Hospital, Soni Falia, SURAT-395003. (Gujarat) INDIA.

Consulting Time: 1 pm to 6 pm (Indian standard time)
Telephone:  +91-261-2591146
(R)  +91-261-2730897

E-mail: rohit@alopeciacure.com

Alternative Email: alopeciacure@hotmail.com
(will be checked weekly)
Support Center in USA :

Holly McGuffin

Livonia,
MI 48152 USA 

Preferable time to call:
8 am - 10 am and 6 pm to 8 pm
(Eastern Standard Time)
Monday to Saturday
Tel.011+1+248-719-1972
Support Center in UK :

Mrs. Bhavna Patel

Gore Court, Kingbury, London.

Consulting Time: 11.00 am to 6.00 pm
[Ms Bhavna patel has now returned from India completing her short term training course which was held in feb -2010.]
Cell: 0 773 875 2454
     
Support Center in Mumbai :
Crresshhha Polyclinc
Consulting Time: 11 pm to 4:30 pm

Devi Ekveera A Building (Basement), Nr. HDFC, 79, Old Nagardas Road, Andheri (E), Mumbai - 400 069.

Ph.:022-66989770
Schedule 2009
March - 14,28,
April - 11,25,
(2nd and 4th Sunday of the month)
Support Center in Ahmedabad :

Alopecia Treatment Center

Consulting Time: 6 pm to 8 pm Daily

Dr Sunil shah [M.D.], 14/10 Vir-vijay Society, Near Sanghavi High School, Naranpura, Ahmedabad.

Ph.:079-27410607
Schedule 2009
April - 4
Dr. Rohit will visit every first Sunday of the month. (Time 9 am to 5 pm)
Support Center in Haryana :

Dept. of Dermatology (Mahabir Dal Hospital)

Consulting Time: 5 pm to 7 pm Daily

Dr. Meenu Gandhi, Dept. of Dermatology, Mahabir Dal Hospital, Kunjpura Road, Karnal, Haryana.

Ph.:9996629614
     
   
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