Male Androgenetic Alopecia (Hair Loss) Pre-Qualification Questionnaire
Thank you for your interest in this pre-qualification questionnaire. In order to determine if you pre-qualify for this research study, we will ask you a few questions about your Androgenetic Alopecia (AGA) commonly known as hair loss in men and women. You may stop answering at any time and do not need to answer any questions that make you feel uncomfortable. All information you provide will be kept confidential and stored in the secured study database. Your information will be kept in the secured database until the end of the study and then destroyed unless you elect to have us retain your information for potential future trials (see question 13 below).
