Hair Loss Assessment

Find Out What May Be Causing Your Hair Loss in 60 seconds

What is your age group? *

Under 25

25–34

35–44

45–54

55+

What is your gender? *

Male

Female

Prefer not to say

How long have you been experiencing hair loss? *

Less than 3 months

3–6 months

6–12 months

More than 1 year

Where are you noticing hair thinning or loss? (Select all that apply) *

Hairline / temples

Crown area

General thinning across the scalp

Patchy hair loss

Eyebrows or facial hair

Not sure

How severe is hair loss? *

Mild thinning

Moderate hair loss

Significant hair loss / visible scalp

Has anyone in your family experienced hair loss? *

Yes

Not sure

Have you experienced any of the following recently? (Select all that apply) *

High stress

Rapid weight loss

Illness or surgery

Hormonal changes (pregnancy / menopause)

Thyroid issues

Iron deficiency

None of the above

Have you noticed increased hair shedding when brushing or washing your hair? *

Yes

Unsure

Do you currently take any of the following? *

Hair supplements

Hair loss medication (Minoxidil / Finasteride)

Hormone medication

None

What is your biggest concern about your hair? *

Receding hairline

Thinning hair

Bald patches

Excessive shedding

Weak or brittle hair

Have you tried any treatments before? *

Hair growth shampoos

Supplements

PRP treatment

Hair transplant

None

Get Your Personalised Hair Loss Advice

Our doctor will review your answers and advise whether a medical consultation or further assessment may help identify the cause of your hair loss.

First Name *

Last Name *

Email *

Phone *

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