Will My Hair Regrow Back?
Basic Questions To Let Us Help You?
Name
Email Adress
Occuptation
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Do use chemicals wear tight braids and flat irons excessively?
Yes daily
sometimes
not often 2xa year
never
Whats your age range?
9-21
22-35
36-47
48-58
59-65
65 and up
Are you currently taking medication that causes hair loss.
yes
no
im not sure
What level of stress are you currently under?
Somewhat just a little very minimal
normal regular stress
Constant Stress
Excessive Stress
Are you exposed to chemicals on a regular basis?
yes daily
weekly
2-4x a month
4x a year
Have you recently changed your diet?
Yes
NO
Im always trying something new
Burn Out Quiz ***Bonus
Do you have to have coffee every morning?
yes
no
Do you deal with irritability or anger problems?
yes
no
Do you have to exercise excessively to experience peace and energy
yes
no
Do you love listening to loud music and love going to the club?
yes
no
Are you dealing with personal or relationship stress with a spouse or relative?
yes
no
Do you drink alcohol, excessive carbs, smoke regularly?
yes
no
Do you have restful deep sleep regularly 8-10hrs?
Yes
No
Submit
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