Trichologist Analysis

Do you suffer from any of the following? Thinning, shedding, breakage or general hair loss?

If so and you would like some advise fill in this Hair Lose Questionnaire and our Trichologist and Hair Loss Specialists will review your answers and be in contact with recommendations.

Gender

Is your hair thinning/shedding?

Where are you experiencing thinning/shedding?

Have you experienced hair loss before?

How long have you been experiencing hair loss?

Do you experience hair loss elsewhere on the body?

Does your hair easily break/snap?

Is your scalp:

Are you on any kind of diet? Calorie controlled or specific e.g. vegetarian.

Are you currently:

Have you recently undergone any kind of:

Have you ever had:

Do you ever have chemical hair treatments?

Have you had a ‘bad reaction’ to a chemical hair treatment?

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