Rabbit Check-In Form

Rabbit's Owner's Information

Owner's Name (required)

Owner's Phone Number (required)

Owner's Email (recommended)

Rabbit's Information

Rabbit's Name (required)

Rabbit's Sex (required)

Rabbit's Breed (required)

Rabbit's Age (required)

Rabbit Spayed or Neutered? (required)
YesNo

Background Information

Length of Time Owned (required)

Rabbit Acquired Where (required)

How often is the Rabbit handled? (required)

Character of Rabbit's Feces (required)

Husbandry Information

Indoors or Outdoors? (required)

Is the rabbit allowed to roam around free in the house? (required)

Where is the rabbit's cage located? (required)

How large is the rabbit's cage? (required)

What type of caging does the rabbit have? (required)

Is the cage galvanized? (required)
YesNo

What kind of cage subcrate does the Rabbit have? (required)

How often is the cage cleaned? (required)

Products used to clean cage. (required)

Nutrition Information

Does the rabbit regularly eat hay? (required)
YesNo

If yes, what brand of hay, how frequently is the rabbit given hay, and how much?

Does the rabbit regularly eat pellets? (required)
YesNo

If yes, what brand of pellets, how frequently is the rabbit given pellets, and how much?

Are any supplements/treats given to the rabbit? (required)
YesNo

If yes, what kind of treats and how much?

Rabbit's water source(s) (required)

How often is the water changed? (required)

Are there any other pets in the home? (required)
YesNo

If yes, please specify which pets.

Do the other pets interact with the rabbit? (required)
YesNo

If yes, please specify.

Are the animals housed together? (required)
YesNo

If not housed together, where are the other animals located?

Any new additions to the rabbit's household? (required)
YesNo

If yes, please specify.

Past medical history/problems (required).

Current presenting problem (required).

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