The Winning Alopecia Program Application

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Thank you for your interest in The Winning Alopecia Program. Please take a few moments to answer a few simple questions below, so that I can figure out if we would be a good fit to work together.

In my program, I offer a full, self-paced course curriculum AND personalised, ONE-ON-ONE support from me directly to help you achieve results as quickly as possible. I am currently working with a limited number of program participants only.

If I think we may be a good fit to work together, I send you an email. Watch for an email from susychen@winningalopecia.com and check your spam/promotions folders. Otherwise, you will be placed on the program waitlist.

Email *

Your name *

Your email *

How did you hear about me? *

Instagram

Facebook

Google/internet search

Other:

Are you struggling with: *

Alopecia Areata (partial hair loss/patches)

Alopecia Totalis (total hair loss on the head)

Alopecia Universalis (total hair loss on the head and body)

Other:

Is this for yourself (adult) or a child? *

Adult (myself)

Child

In a few sentences, what's the reason for wanting to work with me on overcoming your Alopecia? *

What does an ideal success scenario look like for you as we work together? *

What do you think may be the biggest roadblock(s) that would prevent you from reaching your goals with overcoming Alopecia? For example, ability to make diet changes, time constraint, cost, discipline, etc. *

Which of these best describes your circumstance? *

I am willing and able to invest time and resources into improving my health and making a lasting change

I am curious about how to overcome Alopecia the natural way but not sure if I can commit yet

The Winning Alopecia Program requires a 3-month commitment at the least. Will this be a problem for you? *

Yes

Maybe

The cost of this one-on-one program is in the range of US$1000 (one-time payment, no instalment for the time being). Which of these best indicates your position in regards to financial commitment?

I am aware of the cost and payment term of the program and ready to proceed.

I don't want to or am not able to proceed but I want to hear from you about future offerings.

I don't want to or am not able to proceed and don't want to stay on your mailing list.

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