Selected Value: 1
1 being no quality, 10 being best quality.What are your reasons for giving this number? What can be done to better meet your pet's quality of life needs?What number would you ascribe to your pet for pain using the BEAP scale?
Selected Value: 1
Treatment Plan ConsiderationsWhat medications is your pet currently taking?What types of medications do you think your pet would be willing to accept?Pills/tabletsLiquid by mouthFlavored chewsTransdermal MedicationsInjectable MedicationsOtherIf other, please specifyWhat are your financial concerns surrounding the end of life care plan?Where would you like your pet to receive most of her treatment (home, hospital, etc)?What types of complementary medications would you be interested in (massage, acupuncture, etc)?What are your plans in case of emergency or crisis?What types of diagnostics/testing would you be interested in pursuing? How does your pet tolerate testing (blood work, radiographs)? Where would you prefer to have tests done if possible?What does your pet eat? How much food and water are they drinking?Do you have any upcoming travel plans?Environmental AssessmentWhere does your pet struggle with mobility in the home?Floors (traction, slippery)Stairs (can they go up/down without assistance)Thresholds/Dog Doors (can they step through doorways without stumbling)Clutter in main walkways (do they stumble or trip over objects)Food and Water bowls (at correct height, good traction)Dog Beds (able to get in and out of their bed)Furniture (can they get on/off easily)External pathways (non-slip, free of clutter, not too steep)Car rides (get in and out with ease, settles down once in readily)OtherIf other, please specifyWhat difficulties are you having in keeping your pet clean and free of odor?Preparation for DeathWhat concerns do the people around you have as your pet nears his/her death? If you have children, what level of involvement do you see them having as your pet passes away?Who will be present at your pet's passing?What would be the ideal location for your pet's passing?What is your preference for how your pet's body will be handled after death?Home burialBurial in Pet CemeteryPrivate Cremation with Ashes returnedCommunal Cremation (no ashes returned)OtherIf other, please specifyDo you wish to have a ceremony before or after your pet's passing? Would you be interested in grief counseling or spiritual support?What are your previous experiences with euthanasia or natural death?What questions do you have around the active dying process? Euthanasia?When do you think it might be time to euthanize? Why? *Submit