Healthy Hair Quiz

Hair Loss Self-Assessment Quiz

Instructions:
Answer each question honestly with "Yes" or "No." If you answer "Yes" to several questions, it may indicate that you could benefit from professional assistance.
Name:

First NameLast Name
Best Way to Contact You:

EmailPhone CallTextFacebook/Instagram Messenger
Email Address:*
example@example.com
Phone Number (optional):
Please enter a valid phone number.
Instagram Handle (optional):
How would you describe your natural hair type?

StraightWavyCurlyCoily
How would you describe your hair texture?
How would you describe your hair density (how much hair is on your head)?
How would you describe the length of your hair?

PixieShortMediumLongVery Long
How would you describe your overall hair quality? Check all that apply.

ThinningLacks VolumeDryFrizzyDamagedDyed/ColoredBleach ProcessedMostly Healthy
How would you describe your root/scalp quality?

DryOilyBalancedFlaky/Dandruff
How would you describe the ends of your hair?

DryBrittle/BreakingSplitMostly Healthy
Do you notice an excessive amount of hair on your pillow, in the shower, or on your brush?

YesNo
Have you experienced noticeable thinning or patchy areas on your scalp?

YesNo
What else would you like more information about?

Vegan, Anti-aging SkincareVIP ProgramWellness ProductsBusiness Opportunity
What is your main hair concern right now? Please feel free to share anything else you'd like me to know about your hair!
Is hair loss a common issue among your family members (parents, grandparents, siblings)?

YesNo
Have you noticed a widening part or receding hairline in recent months?

YesNo
Do you experience scalp itching, flaking, or redness regularly?

YesNo
Have you noticed changes in the texture of your hair, such as it feeling finer or more brittle?

YesNo
Have you recently experienced a period of high stress or emotional distress?

YesNo
Are you currently taking any medications known to cause hair loss as a side effect?

YesNo
Have you undergone a significant weight change or restrictive dieting in the past year?

YesNo
Do you follow a low-protein diet, or do you feel you may not get enough nutrients through your diet?

YesNo
Have you noticed more hair shedding in particular seasons (e.g., fall or spring)?

YesNo
Do you frequently use heat styling tools, such as blow dryers or straighteners, without heat protection?

YesNo
Do you wear tight hairstyles (like ponytails, braids, or extensions) regularly?

YesNo
Have you recently experienced any hormonal changes, such as pregnancy, menopause, or thyroid imbalances?

YesNo
Do you regularly use chemical treatments on your hair, such as dye, bleach, relaxers, or perms?

YesNo
Are you currently experiencing a dry or flaky scalp?

YesNo
Have you noticed that your hair seems to be growing slower than usual?

NoYes
Do you smoke or consume alcohol more than occasionally?

YesNo
Are you experiencing high levels of fatigue, poor sleep, or irregular sleep patterns?

YesNo
Have you tried over-the-counter products for hair loss but seen little to no improvement?

YesNo
Results

If you answered “Yes” to 5 or more questions: This may indicate an underlying issue with your hair health that could benefit from professional assessment.
If you answered “Yes” to 10 or more questions: It’s advisable to consult a trichologist or healthcare provider for a thorough analysis and potential treatment options.

Don't wait to reclaim your confidence and beautiful hair! At Hair Eco Salon, we understand that hair loss can be challenging, but you don’t have to face it alone.

Book an appointment with us today to discover personalized solutions tailored just for you. Our expert trichology consultations will dive deep into the root causes of your hair concerns, exploring the latest techniques and treatments to restore and revitalize your hair. Act now—your journey to healthier, fuller hair starts with a single step. Call Hair Eco Salon and let us help you achieve the hair you deserve!

www.hairecosalon.com
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Hair Loss Self-Assessment Quiz

Instructions:Answer each question honestly with "Yes" or "No." If you answer "Yes" to several questions, it may indicate that you could benefit from professional assistance.

Instructions:
Answer each question honestly with "Yes" or "No." If you answer "Yes" to several questions, it may indicate that you could benefit from professional assistance.