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Do you suffer from...? (Select as many as applicable)Do you suffer from...? (Select as many as applicable)DandruffItchy ScalpDry ScalpOily Scalp

How long have you been losing your hair?How long have you been losing your hair?1-3 years3-7 years7-15 yearsmore than 15 years

Would you characterize your existing hair as... Would you characterize your existing hair as...DryOilyNormal

Is the hair growing on the sides of your head?Is the hair growing on the sides of your head?Thin and fullThick and fullThin and slightly receding

Does your scalp excrete excessive sebum (oils)?Does your scalp excrete excessive sebum (oils)?YesNo

Have you ever experienced a build-up of sebum (oil) on your scalp?Have you ever experienced a build-up of sebum (oil) on your scalp?YesNo

Does your scalp ever flake?Does your scalp ever flake?YesNo

Do you ever see red blotches on your scalp?Do you ever see red blotches on your scalp?YesNo

How would you rate your current rate of hair loss? How would you rate your current rate of hair loss?LightModerateHeavy

Have you experienced an increase in your rate of hairloss in the past year?Have you experienced an increase in your rate of hairloss in the past year?YesNo

Have you ever tried to do anything about your hair loss?Have you ever tried to do anything about your hair loss?RogaineHair TransplantHair ReplacementLotions/ShampooNothing

Have you ever seen a doctor about your hairloss?Have you ever seen a doctor about your hairloss?YesNo

Has anyone ever metioned your hairloss to you?Has anyone ever metioned your hairloss to you?WifeGirlfriendHusbandBoyfriendMotherFatherOtherNo

Does that bother you?Does that bother you?YesNo

Why do you want to do anything about your hair?Why do you want to do anything about your hair?I look older than I feelI hate the way my hair looksI want to meet younger men/womenPeople make fun of me

Do you want toDo you want toStop the hairloss?Have more hair?

Which picture best decribes your hair loss situation?