Rabbit Adoption Application – Southeast FL Rabbit Rescue

Are you 18 or older?

Yes

No

STOP! If you are NOT 18 or older, please write your name, phone number and email below and have one of your parents complete the remainder of this form.

Are you 18 or older but living with / dependent on your parents?

Yes

No

If you are living in your parent’s home / dependent on your parents, they will need to agree to and participate in the adoption. Please write their names, phone numbers, and emails.

Name

First

Last

Age

Date of Birth (mm/dd/yyyy)

Phone

Email

Associated people:

Include the name, phone number and email of any additional applicant or “N/A” if none.

Address

City

State/Province

Zip/Postal

Why are you interested in adopting a rabbit?

Do you rent or own your home?

Rent

Own. Property owners name:Own. Property owners name:

I understand I will need to provide a “pet addendum rental agreement” or written consent signed by my landlord.

I understand

Do you live alone?

Yes

No

Please list everyone currently staying in your home (including minors and roommates), their ages and their relationship to you:

Describe your household’s daily and weekly schedule.

Who will be the primary caregiver(s) that will be changing the litterbox, feeding, cleaning the enclosure, brushing, trimming nails, playing, and providing enrichment?

Is the primary caregiver over 18?

Yes

No

If the primary caregiver is under 18, who will supervise to make sure that the care is performed and/or responsible for taking over if the caregiver is not able?

Who will be financially responsible for the cost of food, supplies, and veterinary care (est. $2,000 per year)?

Do you use air fresheners, plug ins, diffusers or incense?

Yes. Please specify:Yes. Please specify:

No

Unsure

Does anyone in your home smoke or vape?

Yes. Please specify:Yes. Please specify:

No

Unsure

Do you use air fresheners, plug ins, diffusers or incense?

Yes. Please specify:Yes. Please specify:

No

Unsure