The Most Powerful Hair Regrowth Formula In The World

Where are you noticing hair loss?

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How much hair have you lost?

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Have you tried hair loss treatment before?

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What results are you looking for?

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Which treatment have you tried most recently?

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How did those treatments go?

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Let's start with the basics

This information helps your doctor determine if you’re eligible for treatment.

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What was your assigned gender at birth?

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Do you currently take any of the following medications?

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Have you had cancer therapy?

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Do you have any of the following medical conditions?

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What specific condition have you been diagnosed with?

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Have you ever been diagnosed with liver problems?

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Please tell us more about your liver disease.

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Have you ever been diagnosed with prostate cancer?

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Was your prostate cancer diagnosed within the past 5 years?

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Do you experience any symptoms of sexual dysfunction?

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Which of the following do you experience the most?

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Do you have or have you had any mental health conditions?

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Which of the following mental health conditions currently affects you the most?

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Please describe any other mental health condition you have.

Please describe as detailed as possible.

In the last two weeks have you been bothered by any of the following?

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Please describe what has been bothering you in the last two weeks.

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Are you experiencing any of the following symptoms on your scalp?

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Please tell us more about the symptoms you are experiencing on your scalp.

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Have you ever used topical minoxidil to treat your hair loss?

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Did you experience any of the following reactions for more than 4 weeks after starting topical minoxidil treatment?

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Please add any medications you currently take.

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Which best describes your hair loss?

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Please describe your hair loss further.

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Do you have any medical condition(s), a history of prior surgeries, or anything else you want to tell your doctor.

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Do you have any allergies?

Include any allergies to food, dyes, prescription or over-the-counter medicines (e.g., antibiotics, allergy medications), herbs, vitamins, supplements, or anything else.

Please list all medications you currently take & all allergies you currently have.

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Do you have any other questions for your doctor?

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Please describe anything you would like to tell your doctor.

Please be as detailed as possible.

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