COMMUNITY SERVICES | Irvine Animal Care Center

Rabbit Owner Surrender Questionnaire

Please answer the following questions as thoroughly and honestly as you can. Your truthful responses can help us find the best possible home for your rabbit, while incomplete or misleading answers will decrease the chances of a successful adoption.

Owner Name:

Preferred Phone:

Email Address:

Rabbits Name

Age

Breed/mix

Gender

Male

Female

Is your pet spayed or neutered?

Yes

Where did you obtain your rabbit and how long ago?

What is the reason for relinquishing your rabbit? Please explain below.

Behavior problems:

Health problems:

Other:

Who is your rabbit's current veterinarian? Provide veterinarian name and hospital name.

What have you been feeding your rabbit on a regular basis?

How would you describe your rabbit's behavior around people (check all that apply)?

Friendly

Unfriendly

Tolerant

Agressive

Quiet

Scared

Good with kids

How would you describe your rabbit's behavior around other animals (check all that apply)?

Good with cats

No experience with cats

Good with dogs

No experience with dogs

Scared

Agressive

Where does your rabbit live?

Inside

Outside

Both

Please explain:

Has your rabbit ever seriously bitten or scratched anyone?

Yes

If yes, how many times?

Describe the circumstances (be specific):

What else should we know about your rabbit?

Upload Your Documents

The following documents are used to verify pet ownership.

Please note: a valid government photo ID and proof of Irvine residency are required attachments; proof of ownership and medical records are optional.

After submission, you may be asked for additional documentation.

Valid Government Photo ID

Click Here to Upload

Proof of Irvine Residency

Click Here to Upload

Proof of Pet Ownership

Click Here to Upload

Medical Records

Click Here to Upload

Recaptcha Response

Be sure to verify that you are not a robot by using the Captcha tool at the below.

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I acknowledge the above information is true to the best of my knowledge. I give permission to the Irvine Animal Care Center to contact my veterinarian and obtain my pet's medical history.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

The City of Irvine takes your privacy seriously. This form asks you to provide the City with certain personal information. Such information is being requested and will be utilized by the City for the specific and limited purpose of future City correspondence regarding the subject-matter of this form. Pursuant to Measure S, an initiative ordinance passed by City voters in 2008, all information provided on this form will be kept confidential. Unless you expressly indicate to us otherwise or unless compelled by a court order, it will not be shared with other agencies, businesses or individuals.