Are You Ready? Laser Hair Therapy Do you want to find out if you're a good candidate for laser hair therapy? If you'd take a moment to answer the following questions, we'll review your responses and let you know. There's no obligation for responding. What is your age?*Under 2525-4041-55Over 55Are you:*MaleFemaleAre you taking any medications found on our list of medication that can cause hair loss?*(View the list of medications here.)YesNoHave you tried other methods to remedy your hair loss?*YesNoDo you have any diagnosed scalp conditions?*YesNoDo you have a family history of hair loss?*YesNoWhen did you first start experiencing hair loss?*Within the last 6 monthsWithin the past yearWithin the past 5 yearsMore than 5 years agoName* First Last Email* How did you hear about us?*Internet searchSalonAdvertisementWord of mouthNameThis field is for validation purposes and should be left unchanged.