Mobility/Cognitive Dysfunction Questionnaire My Cat is... Your Cat's Name* Your Name* Less willing to jump up and down Yes No Maybe N/A Will only jump up or down from lower heights Yes No Maybe N/A Shows signs of being stiff at times Yes No Maybe N/A Is less agile than previously Yes No Maybe N/A Cries when lifted Yes No Maybe N/A Shows signs of lameness or limping Yes No Maybe N/A Has difficulty getting in or out of the cat flap/cat door Yes No Maybe N/A Has difficulty going up or down stairs Yes No Maybe N/A Has more accidents outside the litter box Yes No Maybe N/A Spends less time grooming Yes No Maybe N/A Is more reluctant to interact with me Yes No Maybe N/A Plays less with other animals or toys Yes No Maybe N/A Sleeps more and/or is less active Yes No Maybe N/A Cries out loudly for no apparent reason Yes No Maybe N/A Has become more fearful and/or more aggressive Yes No Maybe N/A Appears forgetful Yes No Maybe N/A CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. **Ensure there have been no environmental reasons for the change
