top of page
Pain Clinic - Dog Pain Score

Description of Pain

(0 being no pain and 10 being extreme pain)

Select the number that best describes the pain at its worst over the last 7 days
Select the number that best describes the pain at its least over the last 7 days
Select the number that best describes the pain at its average over the last 7 days
Select the number that best describes the pain as it is right now

Description of Function

Select the number that best describes how pain has interfered with your dog’s ability to do the following  (10 means it completely interferes)

General Activity
Enjoyment of Life
Ability to rise to Standing from Laying Down
Ability to Walk
Ability to Run
Ability to Climb Stairs, Curbs, Doorsteps, etc.

Overall Impression

Select the circle that best describes your dog’s overall quality of life over the last 7 days

Thanks for submitting!

bottom of page