FEMALE ON-LINE

EVALUATION

If you would like to receive a free on-line evaluation please provide the following information and it will be submitted to MHN Hair Studio or call 1-800-HAIR-202.  We will then send you an honest prognosis of what you can expect.

7.      Have you been diagnosed with a specific type of hair loss (choose as many as are applicable)?

          Alopecia           Medical Hair Loss     Genetic

          Hormonal          None

8.      How would you rate your current rate of hair loss (choose one)?

           Light                  Moderate                       Heavy

9.      Is your hair damaged or thinning from:

         Relaxers/Perms                               Color

         Synthetic Hair Attachments         All of the Above

10.    Please specify the areas that your hair is thinning: 

11.    Do you have any scalp conditions?  If so, please describe:
 

MHN Hair Studio will respond within 24 to 48 hours.

Thank you.

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