Rabbit Adoption Application

Rabbit(s) you are applying for (Required. If unknown, just write "unknown" in the field)

Have you ever owned a rabbit?
YesNo

Have you adopted a rabbit from us before?
YesNo

Your First and Last Name (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Primary Phone Number (including area code - required)

HomeWorkMobile/Cell

Alternative Phone Number (including area code - required)

HomeWorkMobile/Cell

Best time to contact you? (required)
9 a.m. - 12 p.m.12 p.m. - 5 p.m.5 p.m. - 8 p.m.Anytime

Email Address (required)

Living Arrangements (check one):
HouseApartmentCondo/TownhomeMobile HomeOther

Do you (check one):
OwnRent, Live w/spouse or roommatesRent, live aloneLiving w/parentsStudent

How long have you lived at this address?
1-3 months3-6 months6-9 months9-12 months1-2 years2-3 years3-4 years4-5 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?
YesNo

If yes, please describe:

Do we have permission to visit your home?
YesNo

If not, please give a reason:

Pet History

Do you currently have any other pets?
YesNo

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?
YesNoUnsure/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 a shelter?
YesNo

Do you anticipate moving soon?
YesNo

If yes, when?

Rabbit-Specific Questions

Please state reason for wanting a rabbit as a companion:

Will this new rabbit become a partner/bonded to another rabbit?
YesNo

If yes, please list the name(s) and age(s) of your rabbit(s) you hope to pair with:

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 veterinarian 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

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

Will your rabbit be caged? If so, what size of cage? What material will the cage be constructed of?

Will the 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?
YesNo

How did you hear about House Rabbit Resource Network? (please be specific)

Any comments or questions:

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

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