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Scalp Analyzer

What is your age?

Under 20 20-30 30-40 40-50 50+

What type of hair loss pattern are you experiencing?

Gradual Thinning Sudden Shedding Bald Spots Receding Hairline No Noticeable Loss

Where is the hair loss most noticeable?

Crown/Top of Head Hairline Overall Thinning Patchy Areas No Specific Area

How does your scalp feel after washing?

Oily/Greasy Dry/Flaky Normal/Balanced

Do you experience dandruff?

Yes, dry flakes Yes, oily flakes No

How often do you wash your hair?

Daily Every other day Twice a week Once a week

Does your hair become greasy quickly after washing?

Yes Sometimes No

How would you rate your stress levels?

High Moderate Low

Do you have any known medical conditions?

Yes No

Email Address

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