Print-Out Version

Name: ______________________________________________


Address: ______________________________________________


_____________________________________________________


Phone: __________________


Email: __________________


Please answer the following questions:

1. Do you now have or have you ever had a rabbit(s) as a pet? __________________
   
   
   
2. How many rabbits do you have at present? __________________
   
   
   
3. How many rabbits have you had in the past? __________________
   
   
   
4. If deceased, what was the cause of death?
   
   
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5. For how long did you have your bunny(ies)? __________________
   
   
   
6. Where do/did you keep your bunny(ies)?
   
   
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7. Where will you keep the bunny(ies) you wish to adopt? ________________________________________________________________________________________________
   
   
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8. Is/was/were your bunny(ies) spayed or neutered? __________________
   
   
   
9. Do/have you use/used veterinary services for your bunny(ies)? __________________
   
   
   
10. If yes, who is your vet? (Include name/address/phone.)
    
    
    ________________________________________________________________________________________________
    
    
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11. May we contact your vet for a reference? __________________
    
    
    
12. If you have no vet, would you like us to suggest one? __________________
    
    
    
13. How many children do you have? Ages?
    
    
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14. Which other pets/animals do you have?
    
    
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15. Will you permit us to come to your home to see how the adopted rabbit will be cared for? __________________
    
    
    
16. Which bunny(ies) do you hope to adopt?
    
    
    ________________________________________________________________________________________________
    
    
    ________________________________________________________________________________________________
    
    
    
17. Why do you wish to adopt this/these bunny(ies)?
    
    
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18. Who will be responsible for the everyday care of the bunny(ies)? Age (if under 18)?
    
    
    ________________________________________________________________________________________________
    
    
    ________________________________________________________________________________________________
    
    
    
19. Have you ever relinquished ownership of an animal? __________________
    
    
    
20. If yes, under what circumstances?
    
    
    ________________________________________________________________________________________________
    
    
    ________________________________________________________________________________________________
    
    
    
21. Have you received a Rabbit Habit information packet? __________________
    
    
    

Adoption fees are $50 for a single bunny and $45(each) for two or more bunnies. These fees are used exclusively to cover the cost of spaying or neutering. Thank you for your interest in rabbits!!