InstagramThis field is for validation purposes and should be left unchanged.This field is hidden when viewing the formtemp idThis field is hidden when viewing the formutm_contentThis field is hidden when viewing the formutm_sourceThis field is hidden when viewing the formutm_mediumThis field is hidden when viewing the formutm_campaignLet’s build your hair profile 1 2 3 That’s all we need! Your answers are ready for doctor assessment. Press ‘Continue’ to see your personalised plan. 1 2 3 Let’s start your assessment The Hairy Pill® is different for men and women. Choose the option that’s right for you.i The Hairy Pill® is different for men and women.Choose the option that’s right for you.i Treatment options differ based on biological factors that affect hair loss. Choose the option that matches your biology to support the doctor’s assessment.Gender(Required) The Hairy Pill® for Men The Hairy Pill® for Women Select an option By clicking "Continue" you agree to the Terms and Conditions and Privacy Policy .How would you describe your hair right now? How would you describe the current state of your hair? There’s no wrong answer. Just choose what feels most like you. Just choose what feels most like you.How would you describe the current state of your hair? Full head of hair Damaged/weak hair General thinning Postpartum thinning Receding hairline Widening part Receding & widening Balding crown How would you describe the current state of your hair? Full head of hair Weak/brittle hair General thinning Receding hairline Receding temples Balding crown Receding & balding Balding NextWhat are your hair goals? Select all that apply. Your answers guide the doctor's assessment.What are your hair goals?(Required) Reduce hair loss Stimulate hair growth Strengthen hair Increase hair health All of the above NextJust a few medical questions These help our doctors assess your suitability for treatment.Are your trying to conceive, pregnant or breastfeeding? Are your trying to conceive, pregnant or breastfeeding? Yes No Are you taking any medication? i Including prescription and non-prescription medications such as vitamins, supplements etc. Are you taking any medication?(Required) Yes No Untitled(Required)Do you have any medical or health issues?Do you have any medical or health issues?(Required) Yes No Untitled(Required)Do you have any allergies?Do you have any allergies?(Required) Yes No Untitled(Required)ConfirmContinueUnfortunately, The Hairy Pill® isn't suitable at this time. We're sorry, our treatment program isn't suitable while trying to conceive, during pregnancy or while breastfeeding. You can learn more in our article on pregnancy and postpartum hair loss, which explains why it happens and what you can expect as your hair recovers. Once you've finished breastfeeding, if you're still experiencing hair loss, we're here to help. Postpartum hair loss I didn’t mean to press yes Your personalised treatment plan The Hairy Pill®for Men $75 per month Purchase plan Initial doctor phone consultation and assessment. Tailored once-a-day treatment (3 month supply). Clinically formulated with doctor-selected ingredients to support growth and help reduce loss. Ongoing consultations from partner doctors and support from our expert Australian care team. Treatment method developed by world-renowned Australian dermatologist. The Hairy Pill®for Women $75 per month Purchase plan Initial doctor phone consultation and assessment. Tailored once-a-day treatment (3 month supply). Clinically formulated with doctor-selected ingredients to support growth and help reduce loss. Ongoing consultations from partner doctors and support from our expert Australian care team. Treatment method developed by world-renowned Australian dermatologist. $75 per month First 3 months paid upfront: $225 or 4 payments of $56.25 with Info Info or from $10/week with Purchase plan Personalised treatment plan The Hairy Pill® for Men $75 per month subscription Personalised treatment plan The Hairy Pill® for Women $75 per month subscription Your detailsName(Required) First Last Email(Required) Phone(Required)Date of birth(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920i Unfortunately The Hairy Pill is only available for people over the age of 18. Delivery detailsName(Required) First Last Street Address(Required)Address Line 2City/Suburb(Required)State(Required)StateAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaPost CodeUse Shipping address as billing address Use Shipping address as billing address Name(Required) First Last Street Address(Required)Address Line 2City/Suburb(Required)State(Required)StateAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaPost CodeShipping methodShipping method(Required) Express shipping | 1 to 5 business days | FREE Order summary Personalised treatment plan The Hairy Pill® for Men $75 per month subscription Personalised treatment plan The Hairy Pill® for Women $75 per month subscription 3 month upfront cost: $225 Treatment ProgramIncl. 3-month supply $225 Shipping cost: FREE Discount: 3 month upfront cost: $225 Treatment ProgramIncl. 3-month supply $225 Shipping cost: FREE Discount: Coupon Product NameTotal Payment detailsPayment Method(Required) Credit card Afterpay Zip Credit Card(Required) MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name After clicking “Pay now”, you will be redirected to Afterpay to complete your purchase securely. After clicking “Pay now”, you will be redirected to Zip to complete your purchase securely. Pay now
