Street Paws Rabbit Pre-Adoption Application

Street Paws Rabbit Pre-adoption Application
This application does not commit you to an adoption. It is used to screen those interested to make sure the home is a good match for the family and pet.

Rabbits can live to be 10-14 years old. Are you ready for that commitment?

Before you begin the process of adoption, please keep in mind we do not allow any Street Paws rabbit to be housed (or excercised) outside at any time. Rabbits aren't good pets for young children. Our rabbits mucs come back to us for rehoming if you ever find yourself unable to care for them.

We follow the House Rabbit Society protocols. Please educate yourself here before considering adding a Bunny to your home:

https://www.houserabbitga.com/care-diet
https://www.houserabbitga.com/new-rabbit-checklist
https://www.houserabbitga.com/bunny-101-class-handout
This questionnaire must be completed by anyone interested in adopting a pet from Street Paws. We at Street Paws try to place our animals into permanent and responsible homes while matching the pet to you and your lifestyle. NOTE: THE PROVIDING OF FALSE INFORMATION HEREIN WILL RESULT IN THE FORFEITURE OF ADOPTION FEES AND ANY ANIMALS ADOPTED. Street Paws reserves the right to refuse any applicant.*

I AGREE
In order for your application to proceed without delay, please add info@streetpaws.com to your email safe list to prevent our email reply from going directly to spam. Please call ahead to your vet to release ALL vet history. Please list all vet offices you have used on your application. If your pet was spayed/neutered at an alternate location, please either provide documentation or the vet's name and phone number where the pet was altered. If you do not have a vet history/reference, please indicate no vet history below.*

I have read, agree and understand
Date*

MonthDayYear
Date
Pet's name you are interested in adopting*
Where did you hear about this pet?*
Name*

First NameLast Name
Email*
example@example.com
Phone*
Please enter a valid phone number.
Age of Applicant (Please note, we can only accept applications from the potential owner. We do not accept applications on behalf of other family members or friends.)*
Job Title*
Are you or your spouse/partner currently employed?*
Please list occupation & hours/days worked per week (if no, please explain)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at this address?*
How many times have you moved in the last 5 years?*
Do you anticipate moving in the next two years?*
If so, when?
Please describe your home*

Single Family HouseApartmentCondo/Duplex/TownhousePublic HousingStudent HousingMobile HomeMilitaryLive With ParentsOther
Do you rent or own?*
List landlord/apartment complex name & phone number. Enter N/A if you own. *
Do any children live with you?*
Who do you live with?*

AloneOtherSpouse/PartnerParentRoommateFriendsRelatives
How many people live in your household? List relationship and ages.*
Do all members of your household favor having a house rabbit?*
Does anyone in your household have allergies to animals or hay?*
Are you interested in a specific rabbit?*

YesNoSingle rabbit?Pair of rabbits?
Please indicate the reason for adopting a pet. Check all that apply*

A companion for your BunnyChild's PetCompanion for petFamily pet/companion
Do you have a rabbit now?*
Please describe the level of research you have done to date on rabbits and rabbit care. Enter N/A if none.*
Please describe your ideal rabbit. (personality, age, appearance, etc.)*
Please list preferred size in lbs, age, breed in color.*
I must have (please check all that apply)*

a bunny I can holda bunny who will sit in my lapa litter trained bunnya confident bunnya quiet bunnyan affectionate bunnya kisseran active bunnyan easy-going bunnya curious bunnya playful bunnyOther
I don't want:*

a bunny I can't holda messy bunnya shy or scared bunnya bunny who won't sit in my lapa chewera rambunctious bunnya big shredderOther
Have you owned a pet before?*
How will you handle chewing, scratching, or destructive behavior?*
Who would be responsible for taking care of your pet?*
How many hours each day would your rabbit be left alone?*

None, I am always home1-2 hours2-4 hours4-8 hoiurs8-16 hours16 hours or more
Please describe the level of household activity:*
Are you able to take your rabbit for an annual health check?*

NoYes
Could you afford to pay for emergency treatment?*

NoYes
How much money are you willing to spend in a medical emergency for your rabbit?*
Have you ever adopted from Street Paws or another shelter?*

YesNo
If yes, which shelter? If no, enter N/A*
Where is that pet now? Be specific. If no pet, enter N/A*
How many rabbits, other small animals, cats, dogs, puppies, or kittens have you owned in the past 10 years? Where are these pets now? List if currently owned and what type/kind (dog, cat, other, and how many of each with age, sex, and breed). If deceased, please list the cause of death. Be specific and list each pet's name and how long you have had them. If no pet enter N/A*
Are/were your current/past pets spayed or neutered?*
If no, explain and be specific, if yes write N/A*
Are/were your current/past pets shots up to date?*
If no, explain and be specific, if yes write N/A*
If you currently or previously owned a rabbit(s), please describe their diet (including brand of food/hay), including amounts and frequency of feedings:*
What type of litter do you use?*
How often do you change the litter box?*
Current/most recent vet clinic used or N/A if no pets ever owned. *
Vet Phone # or 000-000-0000 if no pets ever owned.*
Please enter a valid phone number.
Additional vet clinics (name and phone number) that have cared for your pets or N/A if no pets ever owned. *
In whose name are the vet records listed (if other than yourself?)*
Are or were your pets on flea prevention?*
If yes, which brand or product? I no, enter N/A*
Do/did your current/past pets live indoors or outdoors?*
Where will your new pet live? Check all that apply.*

CageContained areaFree RunInside onlyOutside onlyOutdoors only, brought inside during extreme weatherOther
Where will your new pet sleep, location of living space?*
Amount of play time per day, please list in hours.*
Amount of time with people per day, please list in hours. *
How much money per month are you willing to budget to care for your rabbit?*
Have you ever turned an animal in to Street Paws, another shelter, or animal control?*
If yes, under what circumstance? If no enter N/A*
Have you ever had to give up one of your own pets?*
If yes, under what circumstance did you give up your pet? If no, enter N/A.*
Has a rabbit died on your premises of RHD, Myxomatosis, Encephalitozoonosis, Pasteurellosis, or unknown causes in the last 24 months?*
What do you plan to do with your pet when you go on vacation or have to leave town for an emergency? How will you provide for your rabbit?*
Are you willing and able to care for your rabbit for the full duration of its life?*

YesNo
What will you do if you can no longer care for your rabbit such as if you had to move and could no longer keep your rabbit, lose your job or become sick?*
What will you do in the event of a lifestyle change, such as incurring a new family member, working more hours, getting a new pet, starting a new hobby, traveling more?*
If you lose the rabbit, what will you do to find him/her?*
Why did you select a house rabbit for a companion?*
Have you had house rabbits before*
I understand that a copy of an official ID such as a driver's license will be required at adoption. *
Would you allow an authorized representative of Street Paws to inspect the premises where the animal is being kept? A virtual home visit may be requested by Street Paws. *
Have you ever been convicted of a felony? If yes, please explain, if no write N/A.*
Is there anything else you would like for us to know? Comments/Questions?*
The health of a rabbit is not guaranteed, and the health or personality of a rabbit can change over time.*

I agree
I will be responsible for all ongoing or one-off costs for medical treatment my rabbit may need.*

I agree
I authorize Street Paws to contact the veterinarian office named above to confirm the medical records/history of my pets. By electronically signing below, I attest to the truthfulness of all my answers and that I have read, understood and agree with the following information. Falsification of any information above will be grounds for rejection of this application and possible removal of adopted pet from my home. Applicant must be 21 years of age or older. Although Street Paws works towards socialization of all animals and would not adopt out an animal that has demonstrated aggressive or potentially harmful behaviors, in submitting this form, I understand and agree that neither Street Paws nor any person or entity associated with, or working with, or on behalf of or as agent of Street Paws is liable for any injury(s), illness or damages that may result from my/our adoption of any animal. I also understand every effort has been made to insure the animal is healthy and all available medical information will be provided at adoption. Animals will be spayed or neutered and have age appropriate vaccinations prior to adoption. Street Paws strongly encourages all adopters to take their new pet to their veterinarian for an exam (at their expense) within 15 days of adoption. Street Paws is not responsible for further medical needs including but not limed to routine vaccinations, internal parasites, fleas, ticks, ringworm, upper respiratory infections, or other medical problem. I also understand that if I can no longer keep the pet, I will contact Street Paws immediately to discuss placement of the pet. the pet shall not be given away, sold or exchanged without prior written permission of Street Paws.*

I agree
Signature*

Clear
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Street Paws Rabbit Pre-adoption Application