How long have you been experiencing hair loss? Less than 6 months6 months to 1 year1-5 YearsMore than 5 years
Are you experiencing excessive shedding? More than 100 hairs a day. YesNo
Select which of the following treatment options, if any, you've considered for hair loss: MinoxidilPropecia (Finasteride)Light therapyOther
Are you currently or have received chemotherapy treatment? YesNo
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