Fill out our questionnaire for a free initial evaluation and tips on how to deal with it.
Choose the option that you think best suits your case and fill in your contact details at the end of the form.
1. What kind of hair loss do you have? ContinuousSeasonal / OccasionalNoneOther
2. Have you identified any skin problems? OilinessDandruff / Dry skinSeborrheaItchingNoneI don't knowOther
3. Years of hair thinning Less than 1 year1-5 years5-10 years10+ yearsNoneOther
4. Hair thinning type AndrogeneticAlopecia AreataI don't knowNoneOther
5. Thinning areas Head Temples / TopHead ScatteredFaceBodyNoneOther
6. Thinning size Stage AStage BStage CNoneOther
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