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Rabbit History From

Client's Name(Required)

Rabbit's Name(Required)

Breed(Required)

Sex(Required)

Male

Female

Age(Required)

Background Information

Length of time owned?(Required)

Where acquired?(Required)

Breeder

Store

Other

Where was the rabbit acquired?(Required)

How often is the rabbit handled?(Required)

Daily

Occasionally

Never

Character of feces?(Required)

Husbandry

Housed indoors or outdoors?(Required)

Indoors

Outdoors

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

Yes

No

Where is the cage located?(Required)

Type of caging?(Required)

Size of caging?(Required)

Galvanized(Required)

Yes

No

Cage Substrate?(Required)

How often is the cage cleaned?(Required)

What type of disinfectant is used when cleaning the cage?(Required)

Nutrition

Type of Food Offered:

Pellets?(Required)

Yes

No

If yes, which pellet brand?(Required)

Amount fed/frequency(Required)

Hay?(Required)

Yes

No

If yes, which hay type?(Required)

Amount fed/frequency(Required)

Supplements offered and frequency? (i.e. fresh grass, carrots, lettuce, etc…)(Required)

Water source?(Required)

How often is the water changed?(Required)

Any other pets?(Required)

Yes

No

Please specify the other pets(Required)

Do other pets interact with the rabbit?(Required)

Any other rabbits?(Required)

Yes

No

Please specify other rabbits(Required)

Are rabbits housed together or singly?(Required)

Together

Singly

If not housed together, where are the other rabbits located?(Required)

Any new additions to the rabbit population?(Required)

Yes

No

Please specify the new additions to the rabbit population(Required)

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Name

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