Men’s Hair Loss Treatment Test – Dermatex San Diego Orange County

TAKE THE TEST. FIND THE RIGHT HAIR LOSS SOLUTION FOR YOU

Hair Loss Treatment Test for Women

Required Fields*
(All information you provide is considered strictly private and confidential and will not be shared in any way).

Your Name (First, Last)*

Email

Phone*

Address

City, State, Zip


Your Current Age

At what age did you notice your hair was thinning?

Using the chart to the right, which stage represents your current stage of hair loss?
Type 1Type 2Type 3

Does hair loss run in your family?
YesNo

Have you ever been diagnosed with Alopecia Areata?
YesNo

Have you been diagnosed with compulsive hair pulling?
YesNo

What hair loss treatments have you tried?
Prescription MedicationHair ReplacementTransplantsWigs

How would you describe your lifestyle?
AverageActiveVery ActiveProfessional

Please describe your current hair loss condition.

How has hair loss affected you emotionally, if at all?

Total Hair Loss Solutions for Men

 

Men's hair loss treatment test - Orange County San Diego

Meet with a professional Dermatex hair loss specialist who will work one-on-one with you to address all your hair loss concerns and help you determine which hair loss treatment or hair replacement solution is right for you.

Thanks to our state-of-the-art technology we will be able to show you the magnified view of your scalp so you can see and understand exactly the condition of your hair and scalp.

Our consultants will take time to discuss your options and answer any question or concerns you may have so you can regain a full head of hair and lead your life on your own terms without the constant anxiety hair loss causes for so many men.

Male Hair Loss Stages

norwood chart for male pattern baldness