Hair Loss Treatment for Men

A licensed doctor reviews your answers before recommending this treatment.

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Treatment

Hair Loss Treatment for Men

€25 — reviewed by a licensed doctor before your treatment is confirmed.

Datos del paciente

Nombre completo del pacienteCorreo electrónicoTeléfono

Fecha de nacimiento

Enter a date up to 21/10/2026.

PPS number (opcional)

Necesario en documentos médicos de tu país. También puedes completarlo en tu perfil más tarde.

Farmacia preferida (opcional)

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IE · Hair loss · Full

This form is for typical male pattern hair loss (receding hairline and/or thinning at the crown). Please upload a clear photo of your scalp/hairline. If your hair loss doesn't fit the usual pattern — patchy bald spots, or sudden all-over shedding — the doctor may direct you to a video consultation instead, since that needs a different assessment.

About your hair loss

Please upload a clear photo of your hairline and crown

How would you describe your hair loss?

How long has this been happening, and does anyone in your family have a similar pattern of hair loss?

Do you have any scalp conditions — psoriasis, eczema, or dandruff/seborrheic dermatitis — or any irritation, redness, or broken skin on your scalp right now?

Any known allergy to minoxidil, finasteride, or propylene glycol?Write "None" if you have none.

Your health

Have you ever been diagnosed with depression, anxiety, or another mental health condition, or has a doctor previously raised concerns about your mood?

Are you currently having thoughts of harming yourself or that life isn't worth living?

Are you currently experiencing any erectile difficulties, low libido, or other sexual difficulties?

Do you have any liver disease?

Are you currently being monitored for prostate problems, have you ever had an elevated PSA test, or is there a family history of prostate cancer?

Are you and a partner currently trying to conceive?

ConfirmationI have read the finasteride patient information about mood and sexual side effects.

Dirección del paciente

Necesaria para documentos médicos y materiales físicos.

DirecciónPiso / unidad (opcional)CiudadEircode (optional)

Consentimiento de uso de datos (RGPD)

Confirmo que los datos anteriores son correctos y consiento en una videoconsulta con el médico seleccionado.Consiento que mis datos personales y médicos sean procesados por Global Health y compartidos con sus clínicas tratantes y red médica — incluidas clínicas en otros países — para fines de atención, mejora del servicio y seguridad. Política de privacidadQuiero recibir actualizaciones de la cita por WhatsApp (opcional)