Vcare clinic E-Treatment

Do you have :

Health Issues at present and in the past :

Allergies if any:

Medication/treatment taken for this health issues:

Surgeries Undergone:

Diet:

Water Intake:

Food Allergies:

Sleeping Hours (per day):

Sleeping Time:

Head Washes:

Products Used:

Hair Drying:

Description of your problem in your words

Do you suffer any other medical conditions like thyroid, diabetes, hypertension, depression, stress, Irregular menstruation cycle, constipation, anemia etc describe here...

Describe if you have done any lab reports like Thyroid, female hormones, DHT, serum, ferritin, any type of biopsy report etc. (skip this if you have not done any lab reports)

Which type of alopecia do you suffer ?

Quality of your hair