His Holiness
Maharishi
Mahesh Yogi
 
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Hair loss

Your answers will enable us to develop your personalized consultation.
Select the consultation type for this disorder. For more information, click on the consultation type.
   Enhanced ($900)

   Additional or Follow-up ($450)
Issues
1) (required) Check one or more characteristics or information relevant to your current case of Hair loss and its symptoms.
Hair falling out caused by Hair loss Hair falling out Dry scalp caused by Hair loss Dry scalp
Hair dry and brittle caused by Hair loss Hair dry and brittle Male pattern baldness caused by Hair loss Male pattern baldness
Baldness caused by Hair loss Baldness Greying caused by Hair loss Greying
Alopetia totalis caused by Hair loss Alopetia totalis Menopausal caused by Hair loss Menopausal
Stress related caused by Hair loss Stress related Diet related caused by Hair loss Diet related
Climate or weather related caused by Hair loss Climate or weather related None caused by Hair loss None
2) (required) Check one or more primary areas to be addressed.
  Left Scalp  influenced by Hair lossLeft Scalp
  Right Scalp  influenced by Hair lossRight Scalp
  Front Scalp  influenced by Hair lossFront Scalp
  Back Scalp  influenced by Hair lossBack Scalp
3) (required) Check one or more Sensations that are predominant in your case of Hair loss.
  Shakiness caused by Hair lossShakiness   Itching caused by Hair lossItching   Numbness caused by Hair lossNumbness   Heaviness caused by Hair lossHeaviness   Weakness caused by Hair lossWeakness   Rawness caused by Hair lossRawness
  Pain caused by Hair lossPain   Stiffness, rigidity and/or tightness caused by Hair lossStiffness, rigidity and/or tightness   Burning caused by Hair lossBurning   Heat caused by Hair lossHeat   None caused by Hair lossNone
4) Check one or more kinds of Pain that you experience in association with your case of Hair loss or its symptoms.
  Sharp pain caused by Hair lossSharp   Dull/Achey pain caused by Hair lossDull/Achey   Burning pain caused by Hair lossBurning   Prickling pain caused by Hair lossPrickling   Stabbing pain caused by Hair lossStabbing   Shooting pain caused by Hair lossShooting
  Unbearable pain caused by Hair lossUnbearable   Constant pain caused by Hair lossConstant   Occasional pain caused by Hair lossOccasional   Intermittent pain caused by Hair lossIntermittent   Acute pain caused by Hair lossAcute   Extreme pain caused by Hair lossExtreme
Current condition
5) (required) Select how often you experience Hair loss or its symptoms.
Frequency of Hair loss
6) (required) Currently, how severe is your case of Hair loss or its associated symptoms?
Duration of Hair loss     mild     moderate     severe     very severe
7) (required) How disabling is your case Hair loss or its symptoms?
Disablity from Hair loss  mildly  moderately  severely  very severely  Not at all
Disorder History
8) (required) Approximately, how long have you had Hair loss or its symptoms?
Duration of Hair loss  years  months  weeks
9) (required) Is your case of Hair loss the result of an accident or another sudden traumatic event?
Hair loss from accident yes  no  unsure
10) (required) Has your case of Hair loss been medically diagnosed?
Hair loss was medically diagnosed yes  no
11) Brief history of your case of Hair loss and its treatment  (optional - up to 250 characters only) 
History of Hair loss
12) How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Hair loss?
Prior MVVT treatments for Hair loss  0  1  2  3  4 or more
12) What was the average percentage of relief you gained as a result?
Percent improvemnt through Hair loss  75-100%  50-75%  25-50%  0-25%  Unsure
Comments
13) Additional comments (up to 250 characters only)
Comments about Hair loss

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