(702) 472–9892

Patient Forms

Fill this form out and bring it to your first visit:

Hair History Form


“Facing hair loss as a woman is agonizing. I was embarrassed and didn't realize there was help out there. I now can go out feeling confident in my appearance. Thank you Dr. Simon. Thank you.”

Sandra L.

Vegas Valley Hair Restoration

2450 W. Horizon Ridge Parkway STE 100
Henderson, NV 89052
(702) 472–9892

Vegas Valley Vein Institute

Our office also provides vein treatment procedures.
(702) 341–7608

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