Heartland Rabbit Rescue - Blanchard, OK

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Adoption Application

First and Last Name *

Address *

Phone *

Email *

Please list family members and other people who live in your household. (Names and ages)
*

Primary caregiver will be:
*

Do all members of your household favor having a house rabbit?
*

Yes

Other:

Does any member of your household have allergies to animals or hay? If so, please explain.
*

Yes

Other:

Have you adopted from us before? If yes, please explain.
*

Yes

Other:

I am looking for…
*

Single Bunny

Bonded Pair

Other:

I am interested the bunny named:
*

This adoption is for...
*

Myself

A Child

A Gift

Other:

This bunny will live mostly
*

Inside

Outside

Both

Other:

How many hours per day are you away from the home?

1 - 4 hours per day

4 - 8 hours per day

8 or more hours per day

Other:

Clear selection

Please describe the level of household activity:

Quiet

Active

Other:

Clear selection

Housing (check all that apply)
*

Own

Rent

Live with Parents

Have Roommates

House

Apartment / Condo / Townhouse / Duplex

Other:

Required

How long have you lived at your current address?
*

If you rent, please provide Landlord's Name and Phone.

Do you anticipate moving in the next two years? If so, when?
*

Yes

Other:

Please list all current pets in the household. Include Type - Breed - Age - Sex - Neutered/Spayed (i.e Dog - Pug - 3yrs - Male Neutered)
*

Have you had house rabbits before?
*

Yes

Other:

Do you have a rabbit now?
*

Yes

Other:

Why did you choose to adopt a rabbit as opposed to another type of animal?
*

How long have you been thinking about adopting a rabbit?
*

Please describe the level of research you have done to date on rabbits and rabbit care:
*

Preliminary internet research

Extensive internet research

Books and Videos

Friend with rabbit experience

Pet Store

Breeder

None

Other:

If you currently have a rabbit, please describe their current diet, including amounts and frequency of feedings:
*

What type of litter do you use?
*

How often do you change the litterbox?
*

Daily

Weekly

Bi-Weekly

Other:

Please describe your bunny’s living conditions:

Free Roam

Contained Area (like X-Pen)

Crate / Cage

Other:

Location of living space:
*

Amount of time with people per day:
*

How much money per month are you willing to budget to care for your rabbit?
*

$25

$50

$100

Other:

Are you willing to pay for veterinary care if this rabbit becomes sick or injured?
*

Yes

Other:

Are you willing to ensure this bunny receives yearly veterinarian check-ups?
*

Yes

Other:

Would you agree to a scheduled home visit by one of our volunteers?
*

Yes

Other:

When you leave home on vacations or business trips, how will you provide for your foster rabbit?
*

If you lose the rabbit, what will you do to find him or her?
*

Have you ever surrendered an animal to a shelter? If so, please describe the circumstances.
*

Yes

Other:

Have you personally ever given away any of your pets? If so, please describe the circumstance.
*

Yes

Other:

Would you like a veterinarian referral?

Yes

Other:

Would you like info on caring for rabbits?

Yes

Other:

Clear selection

Would you be interested in volunteer work?
*

Yes

Other:

How did you hear about Heartland Rabbit Rescue? *

Website

Community Event

Friend / Family

Other:

Your comments or questions:
*

I hereby certify that all the information on this application is true, and I understand that false information may void this application and any future applications. I also understand that failure to comply with future requirements could result in my inability to foster more animals from this organization.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms