Hair Analysis - Intclinics.com for Partners

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Hair Analysisintclinics2022-11-15T18:18:31+00:00

- Step 1 of 9

Please select your gender.

Male
Female
Other / Prefer not to say

What is your age?

For how many years have you been experiencing hair loss?

What is your natural hair color?

Black
Ginger
Brown
Blonde
White/Grey

Select your frontal area hair loss

Mild
Moderate
Large

Select your crown area hair loss

Mild
Moderate
Large

Have you ever had hair transplantation?

Yes
No

How would you describe your hair loss?

Mild
Moderate
Large
Full

Full Name *

Phone *

Email *

Do you have any questions, concerns, or comments ?

File Upload

Click or drag files to this area to upload. You can upload up to 4 files.

You can upload pictures of your head by showing 4-5 different angles.