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Home
Our Hospital
Our Doctors
Hospital Tour
Payment Options
Forms
Request an Appointment
New Client Form
PetDesk
Promotions
Careers
AAHA-Accredited Hospital
Paisley Paws
Services
Wellness Exams
Dental Care
Senior Wellness
Surgery
Spay & Neuter
Services
Urgent Care
Shop Online
Contact Us
810-985-8300
Make An Appointment
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Rabbit History Form
Rabbit History Form
"
*
" indicates required fields
Date
*
MM slash DD slash YYYY
Name of Rabbit
*
Breed
*
Sex
*
Male
Female
Age
*
Is this a pet rabbit or are you a breeder?
*
Pet Rabbit
Breeder
Background Information
Length of time owned
*
Where was the pet acquired?
*
Pet Store
Other
If other, please specify
*
How often is the rabbit handled?
*
Daily
Occasionally
Never
Character of Feces
*
Husbandry
Housed indoors or outdoors?
*
Indoors
Outdoors
Is rabbit allowed to roam free in the house?
*
Yes
No
Where is the cage located?
*
Type of caging
*
Galvanized?
*
Yes
No
Size of caging
*
Cage substrate?
*
How often is cage cleaned?
*
What type of disinfectant is used when cleaning cage?
*
Nutrition
Are pellets offered?
Yes
No
If yes, what brand?
*
Amount fed/frequency
*
Is hay offered?
*
Yes
No
If yes, what type?
*
Amount fed/frequency?
*
Supplements offered and frequency
i.e. fresh grass, carrots, lettuce, etc
Water source?
*
How often is water changed?
*
Any other pets?
*
Yes
No
If yes, specify
*
Do other pets interact with rabbit?
*
Yes
No
Any other rabbits?
*
Yes
No
If yes, specify
*
Are rabbits housed together or apart?
*
If not housed together, where are the other rabbits located?
*
Any new additions to the rabbit population?
*
Yes
No
If yes, specify
*
Past medical history/problems
Current presenting problem
*
Duration of complaint
*
Phone
This field is for validation purposes and should be left unchanged.
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