Foster Questionnaire

Your Info

Your Household

Please list first name & age of family members and other people who live in your household, including roommates, students, etc.

The primary caregiver will be:

Do all members of your household favor having a house rabbit? —Please choose an option—YesNoUndecided

Does any member of your household have allergies to animals or hay? —Please choose an option—YesNoUnknown

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

Please describe the level of household activity: —Please choose an option—QuietActive

Housing (check all that apply):
OwnRentLive with ParentsSchoolMilitaryHouseCondoApartmentMobile Home

References

Please give us two personal references from people who can attest to your commitment to your animals:

1. Name:
   Phone Number:
   Relationship to you:

2. Name:
   Phone Number:
   Relationship to you:

Who is your current veterinarian?
Vet's Phone Number
May we contact him or her as a reference for you? —Please choose an option—YesNoI don't have a vet

Hopes and Expectations

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

Have you had house rabbits before? —Please choose an option—YesNo
Do you have a rabbit now? —Please choose an option—YesNo

How long have you been thinking about fostering a rabbit?

Please describe the level of research you have done to date on rabbits and rabbit care:
None yetHouse Rabbit SocietyBreederFriend with rabbit experienceHouse Rabbit HandbookOther books on rabbit carePreliminary internet researchExtensive internet researchPet StoreOther

Pet History

Please list all animals currently in the household:
Please note: In order to be an intake foster, you must not currently own any other rabbits, due to RHD.

1. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long has he/she been with you?:
   Where did you get him/her?:

2. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long has he/she been with you?:
   Where did you get him/her?:

3. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long has he/she been with you?:
   Where did you get him/her?:

4. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long has he/she been with you?:
   Where did you get him/her?:

Please describe the animals, including rabbits, no longer in your household:

1. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long was he/she with you?:
   Where did you get him/her?:
   What happened to him/her?:

2. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long was he/she with you?:
   Where did you get him/her?:
   What happened to him/her?:

3. Type:
   Age:
   Sex:
   Spayed/Neutered? —Please choose an option—YesNo
   Kept: —Please choose an option—InsideOutsideBoth
   How long was he/she with you?:
   Where did you get him/her?:
   What happened to him/her?:

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

Have you personally ever given away any of your pets? If so, please describe the circumstances:

Ongoing Care

Please describe your plans for your foster bunny's living conditions:
Please note: Foster rabbits must be kept indoors only.
CageContained areaFree roam
If Cage or Contained Area, please provide dimensions:
Location of living space:
Amount of play time per day (hrs):
Amount of time with people per day (hrs):
Are you willing and able to transport the bunny to the vet if needed? YesNoDepends (Please elaborate)
Are you willing to take the bunny to adoption events? If so, how often?

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, such as spaying or neutering, could result in my inability to foster more animals from this organization.
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