Health Questionnaire

Bad breath, drooling, avoiding chew toys, dropping food.

Change in activity level.

Change in appetite or weight.

Change in attitude or responsiveness.

Change in sleep patterns.

Change in urination (amount or frequancy).

Change in water consumption.

Confusion or disorientation.

Constipation, diarrhea, or vomiting.

Coughing or sneezing.

Heavy or rapid breathing.

Dribbling urine or waking up in puddles.

Lethargy or depression.

Lumps or bumps on or under the skin.

Noticeable decrease in vision (e.g., bumping into furniture).

Shaking head (on & off continuosly).

Stiffness (e.g., trouble jumping, climbing stairs, or walking).

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