1. How old are you?

2. How many hairs are you losing now?

How do I count the hairs I lose on a daily basis?

You can determine your daily hair loss in three steps:

Each morning, count how many hairs you find on your pillow.

Then comb out your hair over the sink using a comb or a brush. Count the number of hairs in the sink and in the comb/brush.

Repeat this every evening.

The total of these three counts will give you your daily hair loss.

Few (0 - 20)

Slightly increased (20 - 40)

Increased (40 - 80)

Many (80 - 120)

Very many (more than 120)

3. How advanced is your hair loss already?

Stage 1: Full hair

Stage 2: The beginnings of a receding hairline

Stage 3: High forehead and early signs of thinning on top of the head (monk's tonsure)

Stage 4: Clear baldness on the top of the head

Stage 5: Final stage of balding with remaining hair on the neck and at the side behind the ears

4. Do you have dandruff?

Yes

5. Do you wear any headgear, e.g. at work (as a chef, police officer, construction worker) or during your free time (motorbike helmet, baseball cap)?

Frequently

Rarely

Never

6. Are you often stressed?

Yes

Due to chronic time pressure

Due to physical work

Due to increased pressure to perform (e.g. at work or because of exams)

7. Do you have an increased energy demand?

Yes

Due to competitive sports

Due to fitness training

Due to heavy physical work

8. Do any of the men in your family already suffer from hair loss?

Yes, on my father's side

Yes, on my mother's side

Yes, on both sides

9. Please leave your contact information below so we can send you the quiz results.

Where did you hear about us?*

Search Engines (Google, Bing, Yahoo)
Social media - Facebook, Instagram, Tiktok
From a friend/family member
From another doctor
Email from Hair Transplant Melbourne
Text message from Hair Transplant Melbourne
Influencer (which one / channel)
Hairdresser/salon
Radio (incl. Podcast)
Other (please let us know)
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