Name: Email: Mobile: Next Previous Q1: What is your Age-Group ? a) 10-15 Years b) 16-20 Years c) 21-30 Years d) 31-50 Years e) 51 and Above Q2: What is your Hair Type ? a) Straight b) Wary c) Curly d) Kinky Q3: What is your Hair texture ? a) Fine / Thin b) Dense c) Medium d) Coarse Q4: Since How Long are you experiencing Hairfall ? a) 1-3 months b) Since 6 months c) More than 6 months d) More than a year Q5: How much density / volume of hair have you lost in last 6 months ? a)More than 50% b) Up to 30% c) 10-20% d) Less than 10% Q6: Are you taking any medications / supplements currently ? a) Yes b) No Q7: Are you doing any form of execuse / workout daily ? a)Light Exercise b) Gym Training c) High Intensity Workout d) Home workout / Yoga / etc Submit
Name: Email: Mobile: Next Previous Q1: What is your Age-Group ? a) 10-15 Years b) 16-20 Years c) 21-30 Years d) 31-50 Years e) 51 and Above Q2: What is your Hair Type ? a) Straight b) Wary c) Curly d) Kinky Q3: What is your Hair texture ? a) Fine / Thin b) Dense c) Medium d) Coarse Q4: Since How Long are you experiencing Hairfall ? a) 1-3 months b) Since 6 months c) More than 6 months d) More than a year Q5: How much density / volume of hair have you lost in last 6 months ? a)More than 50% b) Up to 30% c) 10-20% d) Less than 10% Q6: Are you taking any medications / supplements currently ? a) Yes b) No Q7: Are you doing any form of execuse / workout daily ? a)Light Exercise b) Gym Training c) High Intensity Workout d) Home workout / Yoga / etc Submit
