1. When did you start losing your hair?
Less than a year
One to five years
Five to ten years
More than ten years
2.Which areas are you more concerned about?
Frontal hair line
Frontal hair line and mild scalp areas
Frontal hair line, mid scalp and crown areas
Crown area only
3. How short do you keep your hair?
Less than 1/4 inch long
Between 1/4 to 1/2 inch long
Between 1/2 and 1 inch longer
Longer then 1 inch
4. Do you still have hair in the some regions of the scalp?
Still have hair all over
General thinning all over
Mostly thinning in front to mid scalp areas
Thinning in the front, mid scalp and crown areas
5. Do you prefer to start with medical or surgical hair treatment?
Interested in surgical procedure
Interested only in medical hair treatment
Interested in both medical and surgical hair treatment
Do not know
6. Have you had any hair loss treatments in the past?
Had medical hair treatment
Had hair transplant surgery
Had hair transplant surgery and medical hair treatment
No treatment in the past
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