Hair loss assessment

Answer a few questions about your hair loss

This short assessment helps a prescriber decide whether treatment is safe and suitable for you.

This form is not for emergencies. If you have chest pain, severe breathlessness, sudden weakness, or feel you might harm yourself or others, contact emergency services immediately.

Step 1 of 7

About you

Sex at birth

Your hair loss pattern

Where is your hair loss?
How long has this been happening?

Type of hair loss

Is your hair loss sudden or patchy?

Your general health

Allergies and past treatments

Used finasteride before?

Your wellbeing

Do you understand results take 3–6 months?
Have you recently felt very low or had thoughts of harming yourself?

Your details