Senior Pet Vet - Quality of Life Assessment

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Client Information* This field is required.

Name

Phone

Email

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General Background

What made you reach out to us?

What are your goals for this appointment?

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What do you feel are your biggest challenges and unanswered questions at this point?

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Share with us your understanding of the disease process and what has been explained to you thus far with regards to “what is going on” with your pet.

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What treatment and/or management options for your pet’s disease have been offered to you?

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What are the signs/symptoms (if any) you are seeing now?

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Do you have any understandable financial considerations or physical/emotional/time limitations with managing your pet’s ongoing care?

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What medications/supplements is your pet currently receiving?

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Does your pet easily take medications?

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What is your pet’s current diet?

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Are you having to feed/encourage intake?

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Would you consider additional or continued diagnostics or simply manage your pets care based on symptoms alone?

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What are your “lines in the sand” with regards to “stopping points” in care?In other words, what don’t you want your pet to experience or what point do you not want your pet to get to? (e.g., if my pet’s pain cannot be controlled, when my pet can no longer get up by himself, when he no longer wants to engage with us as a family...)

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Do you have a preference between euthanasia or a natural death?

What are your previous experiences with euthanasia?

What concerns do you have around euthanasia?

Have you thought about the place you wish to have the passing happen? Who will be present?

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Do you wish to have a ceremony or ritual before or after the passing?

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Do you have plans for aftercare? Cremation vs burial