The Hair & Scalp Institute wants to make your visit as quick and easy as possible. If you have already called to schedule your appointment, please complete this form prior to your first visit to HSI.
No wasted time in the waiting room filling out paper work!
The information on this form is completely private and will be for office use only.
Annual blood tests
The Hair & Scalp Institute also recommends that you obtain annual blood tests to detect potential causes of hair loss.
Along with filling out this online form, bringing a copy of these blood tests to your first appointment with HSI will greatly expedite your diagnosis so you can begin to get your hair back!
You can obtain these simple tests from your primary care physician. If you have completed these tests within the past 12 months they do not need to be repeated. Simply call your primary care physician and request a copy of your results. The following are annual blood tests you should receive to detect potential causes of hair loss:
- ANA - Lupus and related autoimmune diseases.
- CBC/Platelets - Anemias and platelet abnormalities
- C-reactive protein/sedimentation rate - indicator of systematic inflation
- Complete metobolic profile - evaluation of organ function
- Ferritin - Iron metabolism, indirect marker of inflammation
- TSH, T3, T4 - Measures thyroid's ability to generate thyroxine
- Thyroid Peroxidase (TPO), Thyroglobulin (TG) Antibodies - Thyroiditis
- Vitamin D3 - General health, immune function and bone metabolism.
Also, if indicated, we may request that you receive specific blood tests to detect hormonal causes of hair loss. This is HSI's suggested list, but not all-inclusive. These tests will be performed by a specialist:
- DHEA-Sulfate - Male and female pattern hair loss
- Estrogen Profile - Polycystic ovary syndrom, adrenal glad, pituitary
- Free and total testosterone - same as above
- LH AND Prolactin - Pituitary