Tell us About Yourself

How old are you?

18-25
26-35
36-45
46-55
56 and over

How long have you been experiencing hair loss?

Less than 1 year
1-2 years
2-5 years
Longer than 5 years

Does hair loss run in your family?

Yes
No

Are you using any medication for hair loss?

Minoxidil
Finasteride
Minoxidil and Finasteride
Other
None

Do you smoke?

10 cigarettes per day
10-20 cigarettes per day
> 20 cigarettes per day
No

Do you drink alcohol?

Daily
2-3 times per week
Once a week
Once a month
Less than once a month
Never

How much do you know about hair transplants?

I know people who did it
I'm still researching
Not much, I need more info

Where do you live?

United Kingdom
Ireland
USA
Spain
Germany
Other

Are you interested in any other treatments?

Medical Consultation
Botulinum Toxin
Skin Care
Fillers
Threads
PRP
IV Drips
Other
No

Are you looking to go with a group of friends?

No, it's just me
Yes, group of 2
Yes, group of 3
Yes, group of 4
Maybe

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