When did you first notice your hair loss?

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Where are you noticing hair thinning or loss?

Has your hair loss been getting worse recently?

Has a doctor ever diagnosed you with male pattern baldness (androgenetic alopecia)?

Is there a family history of hair loss?

e.g. father, brothers, uncles

Have you ever used Finasteride or Propecia before?

Have you ever used Minoxidil (Regaine) or any other hair loss treatments

Were you born a male and are you aged 18 years or older?

Do you have any known allergies to medicines, particularly Finasteride or lactose?

Do you have or have you ever had any of the following?

Tick all that apply

Are you currently taking any prescribed or over-the-counter medicines, vitamins or herbal products?

Do you understand the following:

  • Finasteride is for use by men only and should not be handled by women who are pregnant or may become pregnant
  • Results usually take 3–6 months and stop if treatment is discontinued
  • You must stop taking Finasteride and contact us or a doctor if you notice side effects such as low mood, erection problems, loss of libido, or breast changes

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