You have now taken Nourkrin® for 3 months. Please fill in the 3-Month Follow-Up Form below, to the best of your ability.

After submitting this form you will be provided with another 3-month supply of Nourkrin®.
Thank you.

Please fill out the form below (estimated time: 5-6 minutes)

PLEASE NOTE – Your personal data will be held totally confidential and will not be distributed to third parties.

About you

*First Name

*Last Name

*Email

*Phone/Mobile

* Required fields

3-month feedback

*Question 1 of 7

How would you judge the results so far with respect to hair growth?

*Question 2 of 7

Have you noticed any effect with respect to the quality/appearance of your hair?

*Question 3 of 7

Do you feel better and more confident about your hair and its appearance?

*Question 4 of 7

How does it feel to treat your hair growth issue with Nourkrin®, a scientifically-proven treatment that is safe and drug-free?

*Question 5 of 7

Have you noticed any other effects?

If "yes" briefly describe.

*Question 6 of 7

Have you experienced any unwanted side effects?

If "yes" briefly describe.

*Question 7 of 7

Do you wish to continue trialling Nourkrin® for 3 more months?

If "no" please give a reason.

IMPORTANT:

Before continuing with the Trial, you must guarantee that you have used the entire 3-month supply of product.

By clicking the ‘SUBMIT ANSWERS’ button you personally guarantee that you have used the product as described in the Trial instructions, and as per the directions on the product.

PLEASE NOTE – Your personal data will be held totally confidential and will not be distributed to third parties.