HELSINKI CHRONIC PAIN INDEX Step 1 of 137%Today’s Date:* Date Format: MM slash DD slash YYYY Pet’s Name:*Check only one answer – the one that best describes your dog during the preceding week.Rate your dog’s mood:*Very alertAlertNeither alert,Nor indifferentIndifferentVery indifferentPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s willingness to participate in play:*Very willinglyWillinglyReluctantlyVery reluctantDoes not at allPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s vocalization (audible complaining, such as whining or crying out):*NeverHardly everSometimesOftenVery oftenPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s willingness to walk:*Very willinglyWillinglyReluctantlyVery reluctantDoes not at allPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s willingness to trot:*Very willinglyWillinglyReluctantlyVery reluctantDoes not at allPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s willingness to gallop:*Very willinglyWillinglyReluctantlyVery reluctantDoes not at allPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s willingness to jump (eg, into car, onto sofa. . . . .):*Very willinglyWillinglyReluctantlyVery reluctantDoes not at allPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s ease in lying down:*With great easeEasilyNeither easily, Nor difficultWith difficultyWith great difficultyPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s ease in rising from a lying position:*With great easeEasilyNeither easily, Nor difficultWith difficultyWith great difficultyPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s difficulty in movement after a long rest:*NeverHardly everSometimesOftenVery often/alwaysPointsCheck only one answer – the one that best describes your dog during the preceding week.Rate your dog’s difficulty in movement after major activity or heavy exercise:*NeverHardly everSometimesOftenVery often/alwaysPointsTotal chronic pain index score:
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