Intake Form

Answering these questions honestly will not stop Bun Bun Brigade from accepting your animal but will ensure that we are able to provide the correct care for your animal. Please help us to help your animal.

Your Name
City
State
Email *
Best Phone Number *
Does this animal belong to you or another member of your household?	Yes No
Which option best describes this animal at this time	Found and rescued Loose outside Other
If you chose "other", please explain
Was this rabbit adopted from Bun Bun Brigade?	NoYes
What was this rabbit's name at the rescue previously?
Animal`s Name
What type of animal are you surrendering? *	Chinchilla Gerbil Guinea Pig Hamster Hedgehog Mouse Rabbit Rat Snake Terrapin Tortoise
Gender	Male Female
Has the animal been spayed/neutered? *	Yes No Unknown
Has this rabbit been vaccinated for RHDV2? If yes please email proof of vaccination to bunbunbrigadeintake@gmail.com *	Yes has 1 vaccine Yes has 2 vaccines No This animal is not a rabbit I don't know (assume rabbit is not vaccinated)
Colour	Agouti Black Black and Brown Black and Tan Black and White Blue Blue Eyed White Blue Tortie Brown and Black Brown and White Chocolate Cinnamon Copper Cream Fawn Golden Grey and White Grey/Silver Harlequin Lilac Orange Red Red-Eyed White Ruddy Sable Seal Silver Sorrel Sorrel Tortoiseshell Tabby Tabby and White Tan Tan and Black Tan and White Tortie Tortie and White Tricolour Various White White and Black White and Brindle White and Brown White and Grey White and Liver White and Tabby White and Tan White and Torti Yellow and Grey
Breed	African Grey American American Fuzzy Lop American Sable Angora Rabbit Belgian Hare Beveren Britannia Petite Bunny Rabbit Californian Champagne D'Argent Checkered Giant Chinchilla Chinchilla Cinnamon Creme D'Argent Dutch Dwarf Dwarf Eared English Lop English Spot Flemish Giant Florida White French-Lop Gecko Gerbil Guinea Pig Hamster Harlequin Havana Hedgehog Himalayan Holland Lop Hotot Iguana Jersey Wooly Lilac Lionhead Lizard Lop Eared Mini-Lop Mini Rex Mouse Netherland Dwarf New Zealand Palomino Parakeet (Other) Parrotlet Parrot (Other) Pigeon Poicephalus/Senegal Polish Prairie Dog Quaker Parakeet Rat Rex Rhea Rhinelander Ringneck/Psittacula Rosella Satin Silver Silver Fox Silver Marten Skunk Snake Softbill (Other) Sugar Glider Swan Tan Toucan Turkey Turtle
Age (if unknown how long have you had him/her)
Owner`s reason for parting with animal
Has the animal lived with children?	Yes No Not known
If yes, please specify the ages of children and animal`s behaviour
If no, has the animal had frequent contact with children?	Yes No
If yes, please specify the ages of children and animal`s behaviour
Has the animal lived with other animals?	Yes No Unknown
If yes, what types of animals and how did the behave together?
Is the animal used to men and women?
Where did you get the animal from initially?
How would you describe your animal`s behaviour? For example: bold, shy, timid, aggressive, affectionate
How does your animal react to grooming? nail clipping, brushing etc
How does your animal behave at the vets?
Does your animal have any medical conditions that are undergoing treatment?	Yes No
Please explain what conditions and what the treatment is.
Has your animal had any previous operations or treatment for medical conditions?	Yes No
Please specify what operations/treatments and why.
Does your animal have any known allergies?
Is he/she prone to biting?
Has he/she any unusual behavioural habits?	Yes No
Describe unusual behaviors
Has the animal ever been destructive in the house? Please describe	Yes No
If yes, please describe the destructive behavior
Is he/she used to being handled?
Please describe the animal`s current living space
Do you agree to paying the surrender fee of $20 for an unfixed bunny or $10 for a fixed bunny? This fee does not apply if the bunny was adopted from Bun Bun Brigade.
We request that all supplies be donated to the rescue, if feasible. Having the materials they are used to makes the transfer to the rescue much less stressful on the bunny.
By signing and submitting this form, I agree to transfer ownership of the animal referenced to Bun Bun Brigade. To my knowledge, no other person has any right to this animal. I hereby surrender all rights to the animal. I understand that once I relinquish the animal, the animal will not be available to be returned to me. I have read and understand the conditions of this Surrender Form. *	Clear