Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Scoring No = 1 | Sometimes = 2 | Yes = 3Date *Pet's Name * remain family Reflection Mobility & Comfort My pet can move around and change positions comfortably. *NoSometimesYesMy pet rests calmly without labored breathing. *NoSometimesYesMy pet appears relaxed, not anxious or restless. *NoSometimesYesMy pet can get up, lie down, and change position on their own. *NoSometimesYesMobility & Comfort Total:Connection & InteractionMy pet recognizes family or familiar voices. *NoSometimesYesMy pet seeks comfort or closeness when offered. *NoSometimesYesMy pet's personality and "spirit" feel present. *NoSometimesYesMy pet still finds comfort in familiar routines and surroundings. *NoSometimesYesConnection & Interaction Total:Appetite & Hydration My pet eats willingly and with interest. *NoSometimesYesMy pet drinks enough water on their own. *NoSometimesYesMy pet's weight and intake feel stable. *NoSometimesYesMy pet shows interest in food or treats even if appetite varies. *NoSometimesYesAppetite & Hydration Total:Elimination & HygieneMy pet urinates and defecates comfortably without distress. *NoSometimesYesMy pet stays clean and dry; hygiene is manageable. *NoSometimesYesMy pet's skin and coat remain clean and healthy. *NoSometimesYesMy pet can maintain normal elimination habits with dignity. *NoSometimesYesElimination & Hygiene Total:Pain & Physical EaseMy pet shows no obvious pain (limping/stiffness). *NoSometimesYesMy pet tolerates touch and gentle handling. *NoSometimesYesMy pet rests without signs of discomfort. *NoSometimesYesMy pet can easily perform everyday tasks. *NoSometimesYesPain & Physical Ease Total:Time & Daily Rhythm Good days outnumber bad days. *NoSometimesYesMy pet sleeps peacefully through the night. *NoSometimesYesMedications and comfort care are manageable and effective. *NoSometimesYesMy pet's daily routine feels calm and predictable. *NoSometimesYesTime & Daily Rhythm Total:Energy & Engagement My pet shows interest in favorite people or activities. *NoSometimesYesMy pet has calm, content moments during the day. *NoSometimesYesMy pet seems happy or at peace more often than not. *NoSometimesYesMy pet still enjoys moments of curiosity or joy. *NoSometimesYesEnergy & Engagement Total: Caregiver Reflection (Self)I feel able to meet my pet's needs today. *NoSometimesYesI have emotional support and am coping. *NoSometimesYesI believe my pet is comfortable most of the time today. *NoSometimesYesI feel at peace with the care I can provide my pet right now. *NoSometimesYesCaregiver Reflection (Self) Total:Total Points: 24 – 48 = Poor quality of life (may be time to discuss next steps) 49 – 72 = Fair quality of life (monitor closely for negative changes) 73 – 96 = Good quality of life (no need for change at this time)* This assessment is a reflection guide, not a final answer. Every pet’s journey is unique – some pets with chronic illness or injury may still score well while quietly suffering. Trust both your own intuition and your veterinarian’s expertise when considering next steps. We will be here to support you along the way.Send to Myself/Someone ElseYesNoEmail *Submit