House Rabbit Resource Network
Online Adoption Application

General Information

Rabbit (s) you are applying for:

Your Name (required)

Address (required)

City (required)

State (Texas Only)

Zip

Primary Phone (including area code)
home work cell 

Alternative Phone (including area code)
 home work cell

Your Email (required)

Name and Phone Number of person who can always reach you who does not live at the above address:

Living Arrangements: (check one)
 House Apartment Condo/Townhome Mobile Home Other

Do you: (check one)
 Own Rent, Live w/spouse or roommates Rent, live alone Living w/parents Student

How long have you lived at this address? ---1-3 months3-6 months6-9 months9-12 months1-2 years2-3 years3-4 yeard4-5 years5-6 years6-7 years7-8 years8-9 years9-10 years10+ years

List all adult/children members of household (including ages of children):

Does any member of your household have any known allergies to animals?  yes  no

If yes, please describe:

Do we have permission to visit your home?  yes no

If not, please give a reason:

Pet History

Do you currently have any other pets?  yes no

If yes, please describe (include all animals including roommates' animals), type, age, sex, spayed/neutered, kept indoors or outdoors, had how long?

Your veterinarian's name and telephone number:

Is your veterinarian experienced in treating rabbits?  yes no don't know

List pets owned in the past 10 years, other than those listed above. Include type, age, sex, spayed/neutered, kept indoors or outdoors, had how long, when you stopped owning the animals and reason:

Have you ever surrendered an animal to the shelter?  yes no

Do you anticipate moving soon?  yes no

If yes, when? ,

Rabbit-Specific Questions

Please state reason for wanting a rabbit as a companion:

Where will you keep your rabbit when you're not home?

How much time per day will you be able to interact with your rabbit?

If you suddenly relocated or had other drastic lifestyle changes that made it hard to keep your rabbit, what would you do with him/her?

Who will care for your rabbit when you go out of town, or in case of an emergency?

If your rabbit becomes seriously ill or injured and your veterninarian says expensive medical treatment is needed, what will you do?

Do you plan to have your rabbit spayed or neutered? Why or why not?

Have you ever lost a pet? What did you do to find him/her?

To provide food and medical care for this rabbit, I anticipate spending yearly:---$100$200$300$400 or more

In terms of training and care, do you think a rabbit will require more, less, or about the same amount of time and effort as a cat?

Since rabbits tend to chew, how will you bunny-proof your home?

Will your rabbit be caged? size of cage? Material cage constructed of?

Will cage be kept indoors? Which room?

If outdoors, where will cage be in relation to the house, and where in relation to shade and shelter from wind and rain?

How much time will the rabbit be uncaged? Indoors and/or outdoors?

How many hours per day will your rabbit spend alone?

Where will the rabbit sleep at night?

What kind of diet will you provide for your rabbit? What brand of pellets, what kind of hay, which vegetables, what kind of treats?

Are you committed to taking full responsibility for your rabbit's health and welfare for the rest of its life, which could be 10 years or more?  yes no

Any comments or questions:

 I certify, I am 18yrs. of age or older, live within driving distance of Austin, Tx. I have read House Rabbit Resource Network's Adoption FAQ and How to Adopt. I also verify the information provided is true and accurate to the best of my knowledge.