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  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 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   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.
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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