Canine Brief Pain Inventory

Pets Name(Required)

Owner Surname(Required)

Phone

Email(Required)

Pain Inventory

Which number that best describes the pain at its worst in the last 7days.

(0 = No Pain , 10 = Extreme Pain)

Which number that best describes the pain at its least in the last 7 days

(0 = No Pain , 10 = Extreme Pain)

Which number that best describes the pain at its average in the last 7 days.

(0 = No Pain , 10 = Extreme Pain)

WHich number that best describes the pain as it is right now.

(0 = No Pain , 10 = Extreme Pain)

Description of function:

Pick the position or number that best describes how during the last 7 days pain has interfered with your dog's: (0 = Does not interfere , 10 = Compolete Interfers)

General Activity

(0 = Does not interfere , 10 = Compolete Interfers)

Enjoyment of Life

(0 = Does not interfere , 10 = Compolete Interfers)

Ability to Rise to Standing From Lying Down

(0 = Does not interfere , 10 = Compolete Interfers)

Comments

This field is for validation purposes and should be left unchanged.

The Canine Brief Pain Inventory (Canine BPI; www.CanineBPI.com ) copyright is held
by Dr. Dorothy Cimino Brown

Make a Booking