Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Describe your living situation
*
Please select all that apply
Occupation
*
Please also list your hours
Please List Three References
*
Name, Phone #, Relation to you
Are you over 21?
*
Yes
No
Do you have Children or are children over frequently?
*
Yes
No
If So, What are their ages?
*
Please list your veterinarian or veterinarians you have seen in the last 3 years
*
Name, Phone #, Address
Please list your other pets
*
Name, Age, Species
Sex
*
No Preference
Male
Female
Does anyone in the household have allergies?
*
If so, who and to what species
How would you describe your household?
*
Have you ever owned a rabbit before?
*
Yes
No
If So, How many rabbits have you owned in the past?
*
1-3
3-5
5-10
>10
Do you currently own any rabbits?
*
Yes
No
If So, will they be housed with the new rabbit?
*
Yes
No
If they get along
Who will be the primary caregiver for the rabbit
*
Adult
Teenager
Child
Do you have a cage?
*
Yes
No
Size and Description of enclosure
*
What room or area will the rabbit cage be in?
*
How much time will you have to play and interact with the rabbit?
*
If you have other pets, have they lived with a rabbit before?
*
Yes
No
If so, how did they get along?
*
Will you be willing to purchase fresh fruits and vegetables for the rabbit?
*
Yes
No
What type of bedding will you use in their housing?
*
Carefresh
Cedar Chips
Pine Pellets
Fleece
Are you prepared to keep your rabbit for the span of their life?
*
Yes
No
Rabbits need Timothy hay, fresh fruits and veggies, and pellets. Will you be willing to purchase and feed these specific foods to them?
*
Yes
No
Rabbit should visit the veterinarian for regular check ups as well as when there is a problem. Will your be willing to get vet care when needed?
*
Yes
No
Can you commit to caring for this animal its whole life?
*
Yes
No
If anything changes / doesn't work out / your health, will you guarantee that you will return the animal to our facility?
*
Yes
No
Will you be willing to commit to a two week trial period before finalizing the adoption?
*
Yes
No
