Ok, let's get started. Do you agree to the following? I'm an Australian resident, 18 years or over. I agree to the terms and conditions and privacy policy. 1 2 3 4 5 6 7 Checkout Great! Let’s find the right treatment for you. What's your birth sex? There are more gender identities, however treatment is prescribed based on birth sex.What’s your gender?* Male Female Rated Excellent 4.8 / 5 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout Now, let’s get personal. What’s your full name? This is a requirement to prescribe treatment. Name* Name* Amazing result for male hair loss and thinning Heath Amazing result for female hair loss and thinning Sylvie 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout Thanks , tell us... Your date of birth? Remember, treatment is only available if you're 18 years or older.Day / Month / Year* Day Month Year Day / Month / Year Professional, Caring and Outstanding Results! Jeff My hair feels stronger and healthier than it has in a long time Anita 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout Now for the reason you're here. Select the image that best describes your hair.Select Hair Lost Type for Men* Choice 1 Choice 2 Choice 3 Choice 4 Choice 5 Choice 6 Choice 7 Choice 8 Choice 9 Choice 10 Choice 11 Choice 12 Select Hair Lost Type for Women* Choice 1 Choice 2 Choice 3 Choice 4 Choice 5 Choice 6 Choice 7 Choice 8 The Hairy Pill has changed my life! Stuart 1 2 3 4 5 6 7 8 Checkout Thanks! Now we need to know... Are you trying to conceive, pregnant or breastfeeding? Are you taking any medications??* Yes No Rated Excellent 4.8 / 5 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout Thanks! Now we need to know... Are you taking any medications? Including prescription and non-prescription medications such as vitamins, supplements etc.Are you taking any medications? Including prescription and non-prescription medications such as vitamins, supplements etc.Are you taking any medications??* Yes No Please list (including daily dose for any hair loss treatments)* Rated Excellent 4.8 / 5 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout Also... Do you have medical or health issues?Do you have any medical or health issues?* Yes No Please list* Rated Excellent 4.8 / 5 1 2 3 4 5 6 7 Checkout 1 2 3 4 5 6 7 8 Checkout And finally... Do you have any allergies?Do you have any allergies?* Yes No Please list* Rated Excellent 4.8 / 5
