Hair Loss Treatment Awareness Survey
Help us understand public awareness, experiences, and attitudes toward hair loss and available treatments.
Full Name
First Name
Last Name
Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
Have you experienced hair loss?
*
Yes, currently experiencing hair loss
Yes, in the past
No, never
Which of the following hair loss treatments are you aware of? (Select all that apply)
*
Topical treatments (e.g., minoxidil)
Oral medications
Hair transplant surgery
Laser therapy
Natural/home remedies
Other
Have you ever tried any hair loss treatment?
*
Yes
No
How likely are you to consider seeking treatment for hair loss in the future?
*
Not at all likely
1
2
3
4
Very likely
5
1 is Not at all likely, 5 is Very likely
Where do you get most of your information about hair loss treatments?
*
Please Select
Doctor or healthcare provider
Pharmacy/Drugstore
Friends/Family
Internet/Online articles
Social media
Other
If you have any comments or would like to share your experience with hair loss or treatments, please write below.
May we contact you for follow-up questions or to share more information about hair loss treatments?
*
Yes, you may contact me
No, please do not contact me
Submit Survey
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