Thank you very much for your interest in our study on Trichotillomania. We are attempting to understand the role hormones play in hair pulling disorder. The study is conducted under Dr. Jon Grant at the University of Chicago and involves 1 office visit to the University of Chicago and 4 follow up surveys that can be completed at home. Participants will be compensated for their time and travel. The information you provide here will be kept confidential and will not be used for purposes other than seeing if you are eligible to participate in the study.

If you have additional questions, please call 773-702-5523.

* 1. Do you or your daughter pull your hair?

* 2. How old are you?

* 3. What is your gender?

* 4. Where do you pull from?

* 5. How often do you pull your hair?

* 6. Are you menstruating (had your first period)?

* 7. Do you understand English and can respond to questions, both verbally and written, in the language?

* 8. Are you pregnant and/or lactating?

* 9. Are you currently on birth control?