Hair Loss Assessment

1

Disclaimer:This quiz is for informational purposes only and does not constitute formal medical advice. The treatment options provided are general in nature. Medical diagnosis and treatments are available only after confirmation from one of our licensed physicians.

I understand, let's continue

Stop quiz

2

Over what period of time have you experienced hair loss?

Gradually, over the past few years (display male / female pattern block based on sex)

Suddenly, within the past few months (next question)

I have not experienced hair loss. I am interested in prevention. (display male / female prevention block)

3

Where are you losing hair?

Patches (display male/female patchy hair loss block)

All over (next question)

4

How much hair are you losing?

Mild to moderate amount, less than half of my hair. (display male or female shedding / stress hair loss block)

Significant amount, more than half of my hair is gone. (display male/female patchy / severe hair loss block)

5

Where have you experienced hair loss?Select all that apply

Hair line

Crown

Midpart

6

Which best describes your hair type?

Fine (display M/F fine hair block)

Coarse/thick hair (display M/F course hair block)

Textured (display M/F textured hair block)

I don't know

7

Do you experience dandruff symptoms on your scalp?Check all that apply (if any but none checked, display M/F dandruff block)

Mild to moderate itchiness

Flakes

Redness

None of the above

8

Do you experience any of the following rare scalp symptoms?Check all that apply (if any but none checked, display M/F scarring block)

Severe itching or burning

Redness and scale around individual hair follicles

None of these rare symptoms

9

What was your sex assigned at birth?Use for male vs female treatment plan page

Male

Female

10

Do you have thin eyebrows or eyelashes?Show eyebrow / eyelash block. females only. block being made right now.

Yes

No

11

Do you have a thin or patchy beard?Show beard block. men only. block being made in figma now.

Yes

No

12

How old are you?Only relevant for women. If 44 or younger display female options for women aged less than 45. otherwise display female options for 45 and older.

13

Are you pregnant, breastfeeding, or planning to become pregnant?Display pregnancy section. Only for women.

Yes

No

14

What is your email address?

example@example.com

15

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