Dog Health Questionnaire

Does your dog have a good appetite?

Yes

Has a history of being a picky eater

No

Is your dog fed at ground level or elevated?

Ground

Elevated

Where did you get your dog?

Breeder

Rehome

Rescue

Discipline/Sport?

Pet

Agility

Show

Bite sports

Hunting

Other

In the last week, has your dog been active?

Yes

No

In the last week, has your dog had a good willingness to play?

Yes

No

In the last week, have you seen your dog limp?

Yes

No

In the last week, has your dog been sleeping comfortably?

Yes

No

Does your dog have difficulty going on a walk?

Yes

No

Does your dog have any difficulty running?

Yes

No

Does your dog have any difficulty rising from sitting/laying down?

Yes

No

Does your dog have difficulty navigating the stairs?

Yes

No

Does your dog have any difficulty getting on or off furniture/bed?

Yes

No

Does your dog have any difficulty getting in and out of the car?

Yes

No

Does your dog have any difficulty squatting to urinate/defecate?

Yes

No

Does your dog yawn?

Yes

No

Not Sure

Does your dog do the 'downward dog' stretch?

Yes

No

Not Sure

Dog Health Questionnaire

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