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Mexico DHI Gold
Mexico DHI Gold
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Please choose your gender
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How would you define your hair loss?
None
Light
Light-Medium
Medium
Extensive
Completely
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How would you define your hair loss?
None
Light
Light-Medium
Medium
Extensive
Completely
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How would you define your hair color?
Blond
Brown
Ginger
Black
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How long have you been experiencing hair loss?
1
Duration
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Have you ever had a hair trasplant operation before?
Yes
No
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When did you have a hair transplant operation?
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Are you taking any medications or do you have any disease?
Yes
No
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Are you taking any medications or do you have any disease?
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When are you planning to undergo treatment?
As soon as posible
Within 3 month
In 1 year
I haven’t planned it yet
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Almost done. Whom should we deliver the results to?
Name
Email
Phone
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