FOLLICLEXPERTS

FOLLICLEXPERTS

Hair Restoration Center

Your hair restoration journey starts here

Thank you for your interest in FOLLICLEXPERTS. Please complete this brief questionnaire so our team can understand your hair loss and restoration goals.

About 5 minutes 13 questions
01

Personal information

Full name & age
1

Full name & age

Sex

Country of residence

02

Medical & hair loss history

Do you have any medical conditions or relevant health concerns?
2

Do you have any medical conditions or relevant health concerns?

Are you allergic to any medication?
3

Are you allergic to any medication?

Have you received local anesthesia before?
4

Have you received local anesthesia before?

For example at the dentist, in a doctor's office or in a previous surgery.

Are you currently taking any medications or supplements, including PrEP or PEP?
5

Are you currently taking any medications or supplements, including PrEP or PEP?

Are you currently using any hair loss treatments?
6

Are you currently using any hair loss treatments?

Select all that apply. Required for each treatment: name, dose, frequency and years using it, separated by commas.

Do you smoke, vape, use nicotine products or drink alcohol?
7

Do you smoke, vape, use nicotine products or drink alcohol?

Tobacco, vape or nicotine

Alcohol

Have you had a hair transplant before?
8

Have you had a hair transplant before?

Does hair loss run in your family?
9

Does hair loss run in your family?

03

Your restoration goals

Which area would you most like to restore?
10

Which area would you most like to restore?

Tap the areas in order of priority — your first tap is your top priority.

What is your main goal for this procedure?
11

What is your main goal for this procedure?

Select all that apply.

When are you considering surgery?
12

When are you considering surgery?

04

Scalp photographs

After sending this questionnaire, please send 9 clear photographs in the same WhatsApp chat, following our photo guide.

Front
1. Front
Front ¾ left
2. Front ¾ left
Front ¾ right
3. Front ¾ right
Top / crown
4. Top / crown
Left profile
5. Left profile
Right profile
6. Right profile
Back
7. Back
Back ¾ left
8. Back ¾ left
Back ¾ right
9. Back ¾ right
  • Use bright, even lighting
  • Keep your hair dry and in its natural condition
  • Avoid hats, hair fibers and filters
  • Make sure your hairline, scalp and donor area are clearly visible

Important: Please also send a copy of your photographs with the areas you'd like to restore clearly marked.

05

How did you find us?

Where did you first hear about FOLLICLEXPERTS?
13

Where did you first hear about FOLLICLEXPERTS?

Your information is confidential and used only for your evaluation.