Hair Loss Analysis Assessment

Before You Begin

Hair loss can have many contributing factors, including genetics, hormones, stress, nutrition, scalp health, and lifestyle.

This complimentary assessment helps our Hair Follicle Wellness team better understand your concerns so we can provide an Initial Hair Wellness Assessment and recommend the most appropriate next steps.

Please Note: This is not a medical diagnosis and does not replace a professional consultation. Your results are based on the information you provide and are intended to guide your next step. A comprehensive consultation and scalp analysis are required to create a personalized treatment plan.

    *Please answer all questions.

    Contact Information



    (Where we'll send your Initial Hair Wellness Assessment.)

    (optional)

    Assessment

    1. What is your primary hair concern? (Select one)

    Hair sheddingHair thinningReceding hairlineBald spot(s)Widening partHair breakageSlow hair growthScalp discomfort or irritationI'm not sure

    2. When did you first notice your hair concerns? (Select one)

    Less than 3 months ago3–6 months ago6–12 months ago1–3 years agoMore than 3 years ago

    3. Where are you experiencing hair loss or thinning? (Select all that apply)

    HairlineTemplesCrownTop of scalpEntire scalpPatchy areasOther

    4. Has your hair loss been: (Select one)

    Gradual over timeSuddenComes and goesUnsure

    5. How would you describe your scalp? (Select all that apply)

    HealthyDryOilyItchyFlakySensitiveRed or irritatedTight or tender

    6. Have you experienced any of the following within the past 12 months? (Select all that apply)

    High stressHormonal changesPregnancy or postpartumPerimenopause or menopauseSignificant illness or surgeryRapid weight lossStarted new medicationNone of the above

    7. Does hair thinning or hair loss run in your family? (Select one)

    YesNoNot sure

    8. Have you ever tried any hair loss treatments? (Select all that apply)

    MinoxidilPRPHair supplementsPrescription medicationHair transplantHair system or topperProfessional scalp treatmentsNo, this is my first time

    9. Have you ever been told by a healthcare provider that you have any of the following? (Select all that apply)

    Thyroid conditionIron deficiencyHormonal imbalancePCOSAutoimmune conditionNonePrefer not to answer

    10. What would you most like to achieve? (Select up to three)

    Reduce hair sheddingImprove scalp healthRegrow healthier hairIncrease hair densityLearn what's contributing to my hair concernsExplore non-surgical hair restorationRestore my confidence

    11. Which solutions are you interested in learning more about? (Select all that apply)

    Hair Follicle Wellness ConsultationScalp Wellness TreatmentsHair Growth TreatmentsPRPExosome TherapyCNC Hair SystemHair ToppersHair Transplant ConsultationI'm not sure yet

    12. How soon would you like to begin treatment? (Select one)

    As soon as possibleWithin 30 daysWithin 3 monthsJust researching

    13. Is there anything else you'd like us to know about your hair concerns? (optional)

    Thank you for completing your Hair Loss Analysis Assessment.

    Our Hair Follicle Wellness team will review your responses and send your Initial Hair Wellness Assessment to the email address you provided.

    Your assessment will include:
    • An overview of your primary hair concerns
    • Possible contributing factors based on your responses
    • Educational insights to help you better understand your hair and scalp
    • HairLab Chicago services that may be appropriate for your goals
    • Personalized next steps

    Please remember: This assessment is not a diagnosis. Hair loss can have many contributing factors, and a comprehensive consultation with scalp analysis is the best way to determine the most appropriate treatment plan for your individual needs.