ADOPTION APPLICATION

ADOPTION APPLICATION
Date: _____________________
Name: _______________________________________________________________Age:_______________
Address: ________________________________________________________________________________
City: ______________________________________ State: _____________ Zip: ______________________
Phone: ___________________________________ Cell: __________________________________________
E-Mail: __________________________________________________________________________________
Married:____
Children:
Single:____
Yes:____
Other Pets or Animals:
Smoker?
Yes:____
No: ____
No:____Ages: ____________________________________
Yes:____
No:____
If Yes, explain: ___________________________________________________________________________
Living Situation:
Own:____
Rent:____
Employment:
Full-time:____
House:____
Part-time:____
Condo:____
At Home:____
Apartment:____
Extended Travel:____
Employer:________________________________________________________________________________
Address:_________________________________________________________________________________
City: ________________________________________________ State:________ Zip: __________________
Phone: ______________________________________________
Would you be willing to let a hospital representative conduct a
Pre-adoption home visit?
Yes:____
No:____
Would you be willing to let a hospital representative conduct
Post-adoption home visits?
Yes:____ No:____
Would you consider providing temporary foster care to a rabbit?
Yes:____
No:____
Would you be willing to adopt a rabbit that bites/nips?
Yes:____
No:____
Would you be willing to adopt a shy or untamed rabbit?
Yes:____
No:____
Would you be willing to adopt a bonded pair of rabbits?
Yes:____
No:____
Please detail your previous rabbit care experience including types of rabbit, how many years, nature of the
relationship and where the rabbit is now:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Please provide details regarding the diet you plan to feed your rabbit:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Explain what kind of living arrangements you have planned for your rabbit:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What kinds of enrichments will you be able to provide regularly for your rabbit?_________________________
________________________________________________________________________________________
________________________________________________________________________________________
How much out-of-cage time will your rabbit have each day?
________________________________________________________________________________________
________________________________________________________________________________________
How much one-on-one attention or socialization will your rabbit have each day?
________________________________________________________________________________________
________________________________________________________________________________________
If you have cats, dogs or children, how do you plan to keep your rabbit safe from harm?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If your rabbit becomes aggressive toward you, your partner, your children or other household animals, how do
you plan to deal with the problem?____________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Are you willing to work through issues of territoriality, and/or destructiveness such as chewing on cords,
furniture, or other household items? How?______________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If you travel or vacation periodically, what arrangements will you make for your rabbit?
________________________________________________________________________________________
________________________________________________________________________________________
Will you be bringing your rabbit to a specialty veterinarian for annual preventative wellness exams? _________
If your rabbit becomes ill or injured are you financially capable of addressing the cost of specialty veterinary
care? ______________________
Please provide the information about your exotic pet veterinarian:
Vet’s Name: _____________________________________________________________________________
Clinic Name: _____________________________________________________________________________
Clinic Address: ___________________________________________________________________________
City: ____________________________________________________State: _______ Zip: _______________
Are you aware of the potential life-span of rabbits?
Yes:____
No:____
Why have you chosen to pursue rabbit as a companion?_________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Why have you chosen to pursue adoption rather than purchase a rabbit?______________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If we agree to adopt to you, do you agree to return him/her to us in the event that you cannot care for him/her any longer?
________________________________________