Hair Fall And Hair Loss Quiz

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You’re on your way to stronger hair!
Please answer a few questions - and we will personalise your hair fall treatment plan.
You’re on your way to stronger hair!

Let's Get Your Journey Started!
Tell us a little bit about yourself to get started.
What's your name?
Email
Phone

You are only a few questions away from lush & healthy hair!
After a quick, thorough assessment, a Clinikally doctor will design a targeted treatment plan to help you tackle your woes.
How old are you?
12-1718-2425-3435-5455-6465 and older
What is your sex?
MaleFemaleOther

What's Your Specific Concern?
How would you describe your hair loss/hair fall?
My hairline is recedingI am losing hair from top of my headI have heavy hair loss across the headI lose more than 100 strands per day

Let's Talk Hair Pattern!
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Let's Talk Details!
Please elaborate your hair fall & hair loss concerns to help us design a foolproof treatment plan for you.
For how long have you had hair loss/hair fall?
Less than a month1-3 Months3-6 MonthsLonger than 6 months
Which of the following treatments do you get done regularly?
Blow DryingHair CurlingHair StraighteningHair ColouringHighlights or BleachChemical Treatments (Relaxers, Perms) None

Let's Talk Medical History!
Do you have any family history of hair loss?
YesNoNot Sure
Do any of the following apply to you?
History of PCODHypothyroidismPost PregnancyMenopauseOther Stress (Work, Illness etc.)Vitamin Deficiency (Vit D/Vit B12)Change in Diet None
Do any of the following apply to you?
HypothyroidismOther Stress (Work, Illness etc.)Vitamin Deficiency (Vit D/Vit B12)Change in Diet None

Have you previously done any of the following for your hair loss?
Used MinoxidilHair TransplantFinasteride/Hormone pillsHair PRPHome Remedies None
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