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His Holiness
Maharishi
Mahesh Yogi
Skin
Main Category Index
Alphabetic Index
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
Dry scalp
Hair dry and brittle
Male pattern baldness
Baldness
Greying
Alopetia totalis
Menopausal
Stress related
Diet related
Climate or weather related
None
2)
(required)
Check one or more
primary areas
to be addressed.
Left Scalp
Right Scalp
Front Scalp
Back Scalp
3)
(required)
Check one or more
Sensations
that are predominant in your case of Hair loss.
Shakiness
Itching
Numbness
Heaviness
Weakness
Rawness
Pain
Stiffness, rigidity and/or tightness
Burning
Heat
None
4)
Check one or more kinds of
Pain
that you experience in association with your case of Hair loss or its symptoms.
Sharp
Dull/Achey
Burning
Prickling
Stabbing
Shooting
Unbearable
Constant
Occasional
Intermittent
Acute
Extreme
Current condition
5)
(required)
Select
how often
you experience Hair loss or its symptoms.
Daily
Weekly
Monthly
Yearly
Continuously
Varies
Depends entirely on circumstances
6)
(required)
Currently,
how severe
is your case of Hair loss or its associated symptoms?
mild
moderate
severe
very severe
7)
(required)
How
disabling
is your case Hair loss or its symptoms?
mildly
moderately
severely
very severely
Not at all
Disorder History
8)
(required)
Approximately,
how long
have you had Hair loss or its symptoms?
1
2
3
4
5
6
7
8
9
10-15
16-20
21-30
31 or more
years
months
weeks
9)
(required)
Is your case of Hair loss the
result of an accident
or another sudden traumatic event?
yes
no
unsure
10)
(required)
Has your case of Hair loss been
medically diagnosed?
yes
no
11)
Brief history of your case of Hair loss and its treatment (optional - up to 250 characters only)
12)
How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Hair loss?
0
1
2
3
4 or more
12)
What was the average percentage of relief you gained as a result?
75-100%
50-75%
25-50%
0-25%
Unsure
Comments
13)
Additional comments (up to 250 characters only)