Pet Obesity Data Form Survey

1. Breed
For mixed breeds, record the primary breed or if small (0-20 lbs. ideal weight), medium (20-50 lbs. ideal weight), large (50-80 lbs. ideal weight), or extra-large (over 80 lbs. ideal weight).

NOTE: Be sure each pet corresponds to the appropriate number (i.e. "Dog 1" is used to answer all subsequent questions pertaining to "Dog 1.")

Breed For mixed breeds, record the primary breed or if small (0-20 lbs. ideal weight), medium (20-50 lbs. ideal weight), large (50-80 lbs. ideal weight), or extra-large (over 80 lbs. ideal weight). NOTE: Be sure each pet corresponds to the appropriate number (i.e. "Dog 1" is used to answer all subsequent questions pertaining to "Dog 1.") Dog 1
Dog 2
Dog 3
Dog 4
Cat 1
Cat 2
Cat 3
Cat 4

2. Age
Round to nearest quarter year (0.25 – i.e. a dog 1 year 8 months would be recorded as 1.75). Of course, you may not know the exact age of a pet; round to the closest approximation possible.

Age Round to nearest quarter year (0.25 – i.e. a dog 1 year 8 months would be recorded as 1.75). Of course, you may not know the exact age of a pet; round to the closest approximation possible. Dog 1
Dog 2
Dog 3
Dog 4
Cat 1
Cat 2
Cat 3
Cat 4

3. Owner Assessment of Weight
Classify each pet’s weight as thin, normal, overweight or obese.

Be as honest as possible (your pet isn't reading this!).

	Thin	Normal	Overweight	Obese
Dog 1	*Owner Assessment of Weight Classify each pet’s weight as thin, normal, overweight or obese. Be as honest as possible (your pet isn't reading this!). Dog 1 Thin	Dog 1 Normal	Dog 1 Overweight	Dog 1 Obese
Dog 2	Dog 2 Thin	Dog 2 Normal	Dog 2 Overweight	Dog 2 Obese
Dog 3	Dog 3 Thin	Dog 3 Normal	Dog 3 Overweight	Dog 3 Obese
Dog 4	Dog 4 Thin	Dog 4 Normal	Dog 4 Overweight	Dog 4 Obese
Cat 1	Cat 1 Thin	Cat 1 Normal	Cat 1 Overweight	Cat 1 Obese
Cat 2	Cat 2 Thin	Cat 2 Normal	Cat 2 Overweight	Cat 2 Obese
Cat 3	Cat 3 Thin	Cat 3 Normal	Cat 3 Overweight	Cat 3 Obese
Cat 4	Cat 4 Thin	Cat 4 Normal	Cat 4 Overweight	Cat 4 Obese

4. Weight
Round to nearest tenth (0.1) of a pound.

Weight Round to nearest tenth (0.1) of a pound. Dog 1
Dog 2
Dog 3
Dog 4
Cat 1
Cat 2
Cat 3
Cat 4

5. Previous Medical Conditions
Record conditions such as arthritis, heart disease, periodontal disease, chronic skin infections, etc. We are primarily interested in any long-term, chronic or serious medical conditions.

Previous Medical Conditions Record conditions such as arthritis, heart disease, periodontal disease, chronic skin infections, etc. We are primarily interested in any long-term, chronic or serious medical conditions. Dog 1
Dog 2
Dog 3
Dog 4
Cat 1
Cat 2
Cat 3
Cat 4

Pet Obesity Data Form
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Pet Obesity Data Form
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