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Date of Birth
Where have you lived for the last 5 years? Indicate the names of the regions / districts and the approximate period of residence
Do you use external treatments (medicated shampoos, scalp ointments, etc.)? If you use, which ones? Specify the names of the remedies and the approximate frequency of their use
Do you dye your hair? If yes, by what means? Specify the name of the tool and the frequency of use
Have you been ill with Covid-19?
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Region of stay last year.
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Я прочитал(а) и соглашаюсь с обработкой персональных данных и политикой конфиденциальности