Adoption Application

Thank you for taking the time to complete our form. We also accept applications Saturdays from 12:30 – 3:30 at our weekly adoption venue in Centinela Pet & Feed Supplies, 3860 S. Centinela Ave., Los Angeles, CA 90066.

CONTACT INFORMATION

1. First Name
2. Last Name
3. Email
4. Phone
5. Street Address
6. City
7. State
8. Zip code

GENERAL

1. How long have you been looking for a rabbit?
2. Are you looking for a particular rabbit?
3. Who is the rabbit for?
4. For me For a family member For a friend/other
5. Have you contacted other rabbit groups?
6. Yes No
7. If yes, which one(s)?
8. Have you researched rabbit care?
9. Yes No
10. If yes, where?

CURRENT RABBIT(S)

1. Do you have any rabbits now? (If not, skip to the next section)
2. Yes No
3. Number of current rabbits
4. Age range of current rabbit(s)
5. Sex of current rabbit(s)
6. Male Female Some of each
7. Are they spayed or neutered?
8. Yes No Some are
9. Where do you keep your rabbit(s)?

PREVIOUS RABBIT(S)

1. Have you had rabbits before? (If not, skip to the next section)
2. Yes No
3. If yes, how many?
4. Sex:
5. Males Females Some of each Don't know
6. Were they spayed or neutered?
7. Yes No Some were Unknown
8. Where were the rabbits kept?
9. What happened to those rabbits?

OTHER ANIMALS

1. Do you have any animals other than rabbits?
2. Yes No
3. What other animals do you have now?
4. Are they spayed or neutered?
5. What other animals have you had?
6. What happened to them?
7. Do you plan to get any other animals?
8. Yes No
9. If yes, what kind?

HOUSEHOLD

1. How many children live in your household?
2. What are their ages?
3. How many adults?
4. Is anyone in your household opposed to having a rabbit?
5. Yes No Don't know
6. Does anyone in your household have allergies?
7. Yes No Don't know
8. Does anyone in your household have asthma?
9. Yes No Don't know
10. How long have you lived in your home?
11. Do you have any plans to move?
12. No Yes, soon Yes, within 6 months Yes, within 6 months to a year Not sure
13. If you are planning to move, what will happen to the rabbit?

THE POTENTIAL RABBIT(S)

1. Rabbits are much happier living in pairs; would you consider adopting more than one?
2. No - I definitely only want one rabbit Maybe - I will consider it Yes - I would like to adopt more than one I need to do more research
3. Where will the rabbit(s) live?
4. Estimate the amount of time the rabbit will be indoors
5. Who will be the primary caregiver for the rabbit(s)?
6. How many hours per day will the rabbit(s) be left alone?
7. Do you have a rabbit-knowledgeable veterinarian?
8. Yes Not yet
9. If yes, please provide name:

ADDITIONAL CONSIDERATIONS

1. Are you willing and able to provide veterinary care for your rabbit(s)?
2. What would you do if your rabbit becomes ill when you have an important work obligation?
3. If your rabbit becomes ill and it will cost thousands of dollars to treat him or her, what will you do?
4. Will you consider euthanasia if your rabbit is irremediably suffering?
5. Who will care for your rabbit(s) when you go out of town?
6. Are you aware that rabbits like to chew and may want to chew the carpet, walls or furniture?
7. Yes No
8. Is there any behavior you cannot accept in a rabbit?
9. Under what circumstances would you not be able to keep the rabbit(s)?

OPTIONAL

1. How did you hear about our organization?
2. Are you interested in doing volunteer work or fostering a bunny?
3. Additional Comments:

 

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