Root Revival Regrowth Trial Application

Root Revival Regrowth Trial Application

Apply to participate in the limited placement Root Revival Regrowth Trial. Please complete all sections below.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What changes have you noticed in your hair or scalp? (Select all that apply)

Other (please describe)
How long have you been experiencing these changes?
Have you previously tried any hair regrowth treatments?
If yes, briefly share what you’ve tried and your experience.
This trial requires consistency over multiple months with in-studio sessions and at-home care. Are you able to commit to this process?
What draws you to the Root Revival Regrowth Trial specifically? (Short answer — intuition welcome)
Are you able to attend 4–5 in-studio sessions over the next 2-3 months?
If you selected 'Possibly,' please explain your situation.
Anything else you’d like me to know?
This is a limited placement regrowth trial. Submitting an application does not guarantee acceptance. Selected applicants will be contacted personally with next steps.
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