Your name:

Address:

City, State, Zip Code:

E-mail:

Phone:

Describe the qualities you want in a companion rabbit.

How long have you been thinking about adopting a rabbit?

Why do you want to adopt a rabbit?

For whom is this rabbit being adopted?

Name of primary caretaker:

Number of Adults:

Number and ages of Children:

What research or reading have you done and what experience have you had with companion rabbits?

Are you interested in educational materials regarding house rabbits?

Veterinarian Name and Vet Clinic

What do you expect to spend for veterinary services each year for your rabbit(s)?

Plans for housing: Inside or outside?

Describe living area size, location, etc.

Would you like assistance in planning your rabbit's housing?

Do you currently own or rent?

If renting, what pets does your landlord allow?

Landlord’s name, phone number; address

If you move, what will you do with your rabbit(s)?

Name some reasons that may cause you to give up your rabbit.

Is there anyone in your family who is allergic to rabbits or hay?

Under what circumstances, if any, will your rabbit be allowed outdoors?

If your rabbit is allowed outdoors, how will you protect the rabbit from escape and from predators (raccoons, hawks, cats, dogs, people, etc.)?

Please list other pets you've had, past and present. List current animals first.