Hair test - TwakeSSH Transform your hair in 2-Months

Full Name

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Age

Gender

Male Female

Which image best describes your hair loss? (Select one option from Stage 1 to Stage 7)

Hair Concerns - What specific issues are you facing with your hair currently? (Select all that apply)

Do you experience excessive hair shedding? Have you noticed the thinning of your hair? Do you see bald spots or patches on your scalp?

Family History of Hair Loss - Is there a history of hair loss in your family?

From your mother or her relatives From your father or his relatives From both sides No family history of hair loss

Hair Breakage - Is your hair breaking easily?

Last Year's Health History - In the past year, have you experienced any illnesses or health conditions? (Select all that apply)

Yes, I have had illnesses Yes, I have had major health issues like infections or surgeries Yes, I have been diagnosed with conditions like thyroid problems, anaemia, or autoimmune diseases Yes, I have noticed recent health changes or started new medications No, I have not experienced any of these

Hair Shedding - How many hairs do you notice falling out when you shower or use a comb?

Less than 50 hairs Between 50 and 100 hairs More than 100 hairs

Hair Shedding - How many hairs do you notice falling out when you shower or use a comb?

Less than 50 hairs Between 50 and 100 hairs More than 100 hairs

Hair Health Goals - What is your current goal regarding your hair health and appearance?

Lifestyle Habits - Describe your typical daily routine, including diet, exercise, and stress levels

Sedentary with poor diet and high stress levels Moderately active with balanced diet and moderate stress levels Active lifestyle with healthy diet and low stress levels Highly active with strict diet and very low stress levels

How much time do you typically spend on hair care each day?

Less than 5 minutes 5-15 minutes 15-30 minutes More than 30 minutes

Additional Information - Is there anything else about your daily routine that might impact your hair health?

Yes, I frequently use heat styling tools Yes, I use hair products daily No, my routine is hair-friendly No, I have no other concerns affecting my hair Other (please specify)

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