Pain Awareness QuestionnaireName* First Last Age*Date* MM slash DD slash YYYY Please read the following questions and think about your responses as it affects your cat. Please check what BEST describes your cat’s ability to complete the following tasks. 1. The ability to get up from a resting position? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 2. The ability to lie and / or sit down? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 3. The ability to jump up to a low or average height ~ couch, ottoman? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 4. The ability to jump up to higher heights ~ kitchen counter, beds in one attempt? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 5. The ability to jump down ~ how successful and easily is it performed Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 6. The ability to play with toys, chase laser pointer or other objects? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 7. The ability to play and interact with family members or other pets? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 8. The ability to stretch? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all 9. The ability to groom? Effortless Hesitates Hesitates more than normal Occasional, or with noted effort Not at all
