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Hair Care (Hair Loss) Questionnaire
Thank you for participating! This survey is for us to assess the current hair loss pain point.
Thank you again for taking the time to respond.
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* Indicates required question
Email
*
Your email
What is your Full Name?
*
Your answer
What is your gender?
*
Female
Male
Other:
What is your age?
*
<21
21-30
31-40
41-50
51-60
61-70
>70
What’s your occupation?
*
Student
Agriculture, forestry, animal husbandry and fishery
Transportation, warehousing and postal services
IT class
Financial industry
Scientific research and technical services
Cultural education, sports and entertainment
Public administration, social security and social organization
Healthcare
Other:
What do you worry most
*
Job/Work
Health
Money and future
Relationship
Other:
How long have you been experiencing hair loss?
*
< 1 year
1-3 years
3-5 years
5-10 years
> 10 years
What is your hair loss situation?
Still have full coverage but thinning through the part
Thinning on the crown
Receding hair line
Large crown area boldness
Complete boldness
Other:
Clear selection
Are you concerning about hair loss?
*
Yes
No
What solution have you tried?
*
Minoxdil or Other medications
Hair Growth Shampoo
Therapy
Physical Stimulation like Laser
Hair Transplant or Implantation
Hair Tatoo
Wig
Laser Cap
Other Supplement
Nothing
Other:
What works
Your answer
What doesnt work?
Your answer
Are you still using it?
*
Yes
No
If you are still using it, Why?
Your answer
If you dont use it anymore, Why?
Your answer
How do you select product or treatment
self
based on Doctor's suggestion?
based on family and friend's recommendation
Social Netowrk recommendation
TV ads
Other:
Clear selection
What method do you prefer to manage hair loss?
Use a care product at home for treatment
Go to the hairsalon or other care
Go to the hospital for related treatment
Other:
Clear selection
How much is your acceptable price range for a hair growth product?
*
<$50
$50-100
$100-200
$200-500
$500-$1000
>$1000
I don't care as long as it works
Other:
Factors you consider when purchasing a hair growth product (multiple choice)
*
Brand
Price
Package
Technology
Comfortableness
Convenience to use
Efficacy
What do you care?
Brand
Price
Package
Technology
Comfortableness
Convenience to use
Efficacy
What do you care?
What else you want to share?
Your answer
Do you want to subscribe and get latest Rise Technology update delivered directly to your inbox?
Yes
No
Clear selection
Thank you very much for your time! Contact us by
info@myrisetech.com
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