Pet Quality of Life Assessment Form

When evaluating the quality of life of your pet, personalized patient and family information is important when reaching an educated, informed, and supported choice that fits not only your pet's medical condition, but also your wishes and expectations. In short, quality of life applies not only to the pet, it also applies to you!

Score Each Subsection On a Scale of 0-2:

• 0 = agree with statement (describes my pet)
• 1 = some changes seen
• 2 = disagree with statement (does not describe my pet)

0-8: Quality of life is most likely adequate. No medical intervention required yet, but guidance from your veterinarian may help you identify signs to look for in the future.

9-16: Quality of life is questionable and medical intervention is suggested. Your pet would certainly benefit from veterinary oversight and guidance to evaluate the disease process he/she is experiencing.

17-32: Quality of life is a definite concern. Changes will likely become more progressive and more severe in the near future. Veterinary guidance will help you better understand the end stages of your pet's disease process in order to make a more informed decision of whether to continue hospice care or elect peaceful euthanasia.

Resources: Info.LapofLove.com/QOLscale

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