Please fill in this survey if you have alopecia areata.

It takes about 5-10 minutes to complete. You can save and return to the form later if needed.

Thank you for your important contribution.

Page 1 of 9

Loading... Loading...
You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.