Test Page Take a test. To get a customize Solution 20%First Name *Email AddressPhone No. *AgeGenderMaleFemaleWhich image describes your hair loss? *Stage 1Stage 2Stage 3Stage 4Stage 5Stage 6Coin Size PatchHeavy Hair FallSelect at least one option.Which image describes your hair loss? *Stage 1Stage 2Stage 3Stage 4Select at least one option.Do you have a family history of hair loss? *Mother or anyone from mother's side of the familyFather or anyone from father's side of the familyBothNoneSelect at least one option.Do you have dandruff? *NoneYes, Mild that comes and goesYes, heavy dandruff that sticks to the scalp.I have PsoriasisI have Seborrheric DermatitisSelect at least one optionHow well do you sleep? *Very peacefully for 6 to 8 hoursDisturbed sleep, I wake Up at least one time during nightHave difficulty falling sleepSelect at least one optionHow Stressed are you? *NoneLowModerate(work, family etc)High (Loss of close one, Sepration, home, illness)Select at least one optionHave you experienced any of the below in the last one year ? *NoneSevere illness (Dengue, Malaria, Typhoid or Covid)Heavy weight loss / heavy weight gainSurgery / heavy meditationSelect at least one optionAre you currently dealing with any of these health conditions? *NoneAnemia (Low Iron/Haemoglobin)Low Thyroid (Hypothyroidism)AsthmaSinus ProblemsSelect at least one optionDo you feel constipated? *No/RarelyYesUnsatisfactory bowel movementsSuffering from IBS (irritable bowel syndrome)/dysenterySelect at least one optionDo you have Gas, Acidity or Bloating? *YesNoSelect at least one optionHow are your energy levels? *Always highLow when I wake up, but gradually increasesVery low in afternoonLow by evening/nightAlways lowSelect at least one optionAre you currently taking any supplements or vitamins for hair? *YesNoNot SureSelect at least one optionUpload scalp photo which will be used by doctor after you purchase the plan? *Choose FileNo file chosenDelete uploaded fileUPLOAD SCALP PHOTOSubmit Now
