Assessment for Hair Loss

Male pattern hair loss typically:

• Causes gradual thinning rather than sudden hair loss
• Starts at the temples (receding hairline) and/or the crown (top of the head)
• Progresses slowly over months or years
• Often runs in the family
• Does not usually cause redness, scarring, pain, itching, or patchy hair loss

• Sudden or rapid hair loss
• Losing hair in patches, clumps, or evenly across the scalp
• Scalp symptoms such as redness, pain, itching, scaling, or scarring
• Hair loss following illness, stress, weight loss, or medication
• Hair loss affecting eyebrows, beard, or body hair

• Do you understand that you should use reliable contraception, including condoms, while taking this medication to avoid conception? & that finasteride tablets must not be handled by anyone who is pregnant or may become pregnant due to the risk to an unborn baby?
• Do you understand that some studies suggest finasteride may be linked to low mood, depression, suicidal thoughts, and sexual side effects (such as reduced sex drive, erection problems, or changes in ejaculation), although this link is still being researched?
• Do you understand that sexual or mood-related side effects may persist after stopping treatment in rare cases?
• Do you understand that you should stop treatment and seek urgent medical advice if you experience mood changes, suicidal thoughts, or sexual side effects?
• Do you understand that you should see a doctor if you notice lumps, pain, or any discharge from your nipples?

• Do you understand that finasteride must be taken daily and long-term to maintain results?
• Do you understand that it can take 3–6 months to see results and that hair loss may resume if treatment is stopped?
• Do you understand that you should contact us and inform your GP if you experience any side effects, start any new medications, or if your health changes while taking this treatment?

I understand that I should read the patient information leaflet that comes with this medication

I agree to consult with my healthcare provider before starting any new medication. 

I understand that the information provided in this assessment will be reviewed by a licensed pharmacist before my order is processed. 

I consent to my personal and medical information being used to assess my suitability for the prescribed medication.

I understand that my information will be kept confidential and used solely for the purpose of this assessment. 

I confirm that the information provided in this assessment is accurate and complete to the best of my knowledge.

I understand that providing false information may result in my order being cancelled and may have health implications.