ADOPTION APPLICATION Date: _____________________ Name: _______________________________________________________________Age:_______________ Address: ________________________________________________________________________________ City: ______________________________________ State: _____________ Zip: ______________________ Phone: ___________________________________ Cell: __________________________________________ E-Mail: __________________________________________________________________________________ Married:____ Children: Single:____ Yes:____ Other Pets or Animals: Smoker? Yes:____ No: ____ No:____Ages: ____________________________________ Yes:____ No:____ If Yes, explain: ___________________________________________________________________________ Living Situation: Own:____ Rent:____ Employment: Full-time:____ House:____ Part-time:____ Condo:____ At Home:____ Apartment:____ Extended Travel:____ Employer:________________________________________________________________________________ Address:_________________________________________________________________________________ City: ________________________________________________ State:________ Zip: __________________ Phone: ______________________________________________ Would you be willing to let a hospital representative conduct a Pre-adoption home visit? Yes:____ No:____ Would you be willing to let a hospital representative conduct Post-adoption home visits? Yes:____ No:____ Would you consider providing temporary foster care to a rabbit? Yes:____ No:____ Would you be willing to adopt a rabbit that bites/nips? Yes:____ No:____ Would you be willing to adopt a shy or untamed rabbit? Yes:____ No:____ Would you be willing to adopt a bonded pair of rabbits? Yes:____ No:____ Please detail your previous rabbit care experience including types of rabbit, how many years, nature of the relationship and where the rabbit is now: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Please provide details regarding the diet you plan to feed your rabbit: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Explain what kind of living arrangements you have planned for your rabbit: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ What kinds of enrichments will you be able to provide regularly for your rabbit?_________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ How much out-of-cage time will your rabbit have each day? ________________________________________________________________________________________ ________________________________________________________________________________________ How much one-on-one attention or socialization will your rabbit have each day? ________________________________________________________________________________________ ________________________________________________________________________________________ If you have cats, dogs or children, how do you plan to keep your rabbit safe from harm? ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ If your rabbit becomes aggressive toward you, your partner, your children or other household animals, how do you plan to deal with the problem?____________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Are you willing to work through issues of territoriality, and/or destructiveness such as chewing on cords, furniture, or other household items? How?______________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ If you travel or vacation periodically, what arrangements will you make for your rabbit? ________________________________________________________________________________________ ________________________________________________________________________________________ Will you be bringing your rabbit to a specialty veterinarian for annual preventative wellness exams? _________ If your rabbit becomes ill or injured are you financially capable of addressing the cost of specialty veterinary care? ______________________ Please provide the information about your exotic pet veterinarian: Vet’s Name: _____________________________________________________________________________ Clinic Name: _____________________________________________________________________________ Clinic Address: ___________________________________________________________________________ City: ____________________________________________________State: _______ Zip: _______________ Are you aware of the potential life-span of rabbits? Yes:____ No:____ Why have you chosen to pursue rabbit as a companion?_________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Why have you chosen to pursue adoption rather than purchase a rabbit?______________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ If we agree to adopt to you, do you agree to return him/her to us in the event that you cannot care for him/her any longer? ________________________________________