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Rooted in Hair Quiz

A Hair quiz that will take your response & email you a personalized summary of lifestyle changes & hair care habits.

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Start

Question 1 of 20

Please tell me in the fewest words possible, what are your hair challenges?

Question 2 of 20

Are you having abnormal hair shedding? (losing 150+ hairs per day)

A

Yes

B

No

Question 3 of 20

How many months have you been shedding?

A

I am not having abnormal shedding

B

3-6 months

C

Longer than 6 months

Question 4 of 20

Do you have other hair loss on the body?

(Select all that apply)
A

Eyebrows

B

Leg hair

C

Eyelashes

D

Beard hair

E

No

Question 5 of 20

How would you rate your stress from 1 - 5?

A

1

B

2

C

3

D

4

E

5

Question 6 of 20

Do you have any of the following?

(Select all that apply)
A

Anemia (Low iron)

B

Diabetes

C

Heart condition

D

Autoimmune conditions

E

Polycystic ovary syndrome PCOS

F

Thyroid

G

High blood pressure

H

Irritable bowel syndrome

I

Crohn's disease

J

Skin conditions (Psoriasis/Eczema)

K

None of the above

Question 7 of 20

Are you in perimenopause or menopause?

A

Yes

B

No

Question 8 of 20

Do you smoke or vape?

A

Yes

B

No

C

I used to smoke but don't anymore

Question 9 of 20

Do you pull your hair?

A

Yes

B

No

Question 10 of 20

Do you have any of the following?

(Select all that apply)
A

Itching

B

Flakes

C

Oily scale

D

Burning

E

Tingling

F

Crawling sensations

G

Non of the above

Question 11 of 20

How is your nutrition?

(Select all that apply)
A

I am Vegan

B

I am vegetarian

C

I am Low carb

D

I get in my daily amount of protein

E

I eat 1-2 cups of fruit & 2-3 cups of vegetables per day.

Question 12 of 20

What are the areas of your hair loss?

(Select all that apply)
A

All over

B

Spots of hair loss

C

Temples

D

Crown of head (top of head)

E

Front hair line

Question 13 of 20

Has this been a slow progression of hair loss?

A

Yes, over years

B

Within the last 2 years

C

Within the last 6 months

Question 14 of 20

Have you ever had the following for more than a year?

(Select all that apply)
A

Weave

B

Glue on wigs or toppers

C

Extensions

D

Dreadlocks

E

Braids

F

No

Question 15 of 20

Are you on birth control?

A

Yes

B

I have never been on birth control

C

I am not on birth control but have been in the past

Question 16 of 20

Are you on Medication?

A

Yes

B

No

Question 17 of 20

Do you have any of these symptoms? 

(Select all that apply)
A

Abdominal pain

B

Constipation

C

Diarrhea

D

Bloating

E

Gas

F

None of the above

Question 18 of 20

Do you have any of these symptoms?

(Select all that apply)
A

Anxiety

B

Depression

C

Mood swings

D

None of the above

Question 19 of 20

How would you describe your hair?

(Select all that apply)
A

Dry & Brittle

B

Patches of breakage

C

Healthy

D

Unhealthy

E

Ends are dry

F

Fine & thin

G

Thick

Question 20 of 20

Name and Email to send results too. Please double check spelling.

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