Hair Test Dr Nagwani Medfoods Pvt. Ltd. Name *Phone *How old are you? *Gender *Select GenderFemaleMaleTrans GenderWhat does your hair look like naturally? *Select your hair lookStraightWavyCurlyCoilyDescribe your hair quality *Select your hair qualityGood hair qualityDamaged hairDo you feel like you're facing Hair Fall more than usual? *Select your hair fall typeYes, 101 -200 Hairs/day51-100 Hairs/day25-50 Hairs/dayYour hair widening stage *Select your hair wideningNo wideningStarting to see wideningMedium wideningAdvanced wideningCoin size patchesWhat does a single strand of your hair feel like? *Select single strand of your hair feelThinMediumThickIs hair loss a genetic issue in your family? *Select genetic issue optionsYes, Mother or mother's side of familyYes, Father or father's side of familyBothNoneDuration of Hair Fall? *Select optionsDaysWeeksMonthsYearsDescribe your dandruff. *Select dandruff optionsNoYes, Mild that comes & goesYes, Heavy dandruff that sticks to the scalpI have PsoriasisI have Sebhoric DermatitisBlood Pressure *Normal (110/70 to 130/80 mm Hg)Low (Below 100/60 mm Hg)High (140/90 or more mm Hg)Select your blood pressure levelUpload scalp image *Drag and Drop (or) Choose FilesUpload your scalp image from all sidesAre you going through any of these stages? *Select stage optionsNonePregnancyPost-pregnancyMenopauseAre you taking any Prenatal or routine Vitamins? *Select optionsYesNoHave you experienced any of the below in last 1 year? *NoneSevere Illness (Dengue, Malaria, Typhoid or Covid)Heavy weight loss or heavy weight gainSurgery or on heavy medicationYou can select multiple options according to your correct answerAre you going through any of the below? *Anemia (Low Haemoglobin)DiabeticHypertensionLow Thyroid (Hypothyroidism)PCOSAny Other IlnessNoneYou can select multiple options according to your correct answerHow well do you sleep *Select optionsPeacefully for 6-8 hoursDisturbed sleep, I wake up atleast once a nightHave difficulty falling asleepHow stressed are you *Select optionsNot at allLowModerateHighDo you feel constipated? *Select optionsNoYesI have IBSDescribe your energy levels *Select optionsAlways highLow when I wake up, but gradually increasesVery low in the afternoonLow by evening/ nightAlways lowSubmit my answers