Center Valley Animal Rescue
11900 Center Road
Quilcene, WA. 98376
(360) 765-0598
Email: sara@centervalleyanimalrescue.org
Bunny, Guinea Pigs, Rats Adoption Questionnaire
Center Valley Animal Rescue wants to make certain that every animal adopted
goes to a loving, safe home where the animal will be well cared for with people
who are committed to a lifetime of care for the animal. We also want you to
have a successful experience with your new adoptee. If this will be your first
one, we recommend that you read, talk with your veterinarian, and talk with
other people who have the same type of animal.
When you have made the decision that a bunny, guinea pig or rat will fit into
your lifestyle, fill out the following questionnaire. This application will not
only help us make certain we have the right animal for you but may also help
you to consider some aspects of animal care that you had not thought of yet.
When you have completed the form you can e-mail it, mail it or fax it.
We like to make sure we match the right pet with the right people so please
answer truthfully.
Adoption Fees:
Rabbits – $35; 2 for $60
Guinea Pigs - $35; 2 for $60
Rats - $15; 2 for $20
CONTACT INFORMATION
Date_____________
Name _____________________________________
Age_________
Address ____________________________________________________
City ______________________ State ______________ Zip ____________
Phone (home) _______________________ (work) ____________________
E-Mail ________________________________________________________
What is the name &/or description of the animal you are interested in?
_______________________________________________________
Who will have primary responsibility for care of this animal? _________
Do you live in a house or apartment? ______________________
If in a house, do you rent or own? _______________________
Do you have children? If so, how old? _______________________________
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Is anyone in the household allergic to animals or hay? ___________________
Why would you like to adopt this animal from Center Valley Animal Rescue?
Are you willing to have a Center Valley Animal Rescue representative do a
home visit? _______________________________
Will this be your first rabbit, guinea pig or rat? ____________________
If not, what has been your experience with present or past rabbits, guinea pigs
or rats?
_____________________________________________________________
_____________________________________________________________
Will this animal be used for food or as a food source? ____________________
What other animals do you have in your house?
_____________________________________________________________
Have they been spayed or neutered? _____________
Are they current on their vaccinations? ____________
How will you introduce this new pet into the family?
_____________________________________________________________
_____________________________________________________________
General maintenance:
The basic needs of a healthy small animal (food, annual exams, bedding, toys)
can cost $200 - $400 a year! Any health or behavioral problems could increase
this amount.
How much do you anticipate spending yearly for costs like food, veterinary care
and medications (if any)?
________________________________________________________
Do you feel you are in a position financially to provide for this pet’s basic
needs? _____________________________________________
If you go on vacation or will be away on a trip, what arrangements would be
made for animal care?
_____________________________________________________________
Rabbit Environment:
If adopting a rabbit, will it be indoors or outdoors? ______________________
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If adopting an indoor rabbit, is your home rabbit proofed? (electric cords
covered, no chemicals on the floor, plants poisonous to rabbits removed from
rabbit areas, etc)? ____________________________________________
What type of enclosure are you planning to use for the rabbit and where will it
live?__________________________________________________________
How much time will they spend in their enclosure and how much time will they
be allowed to run around? ________________________________________
Guinea Pig or Rat environment:
What type of housing will you have for this small animal and where will it be?
___________________________________________________________
How much time will they spend with their human companion? ____________
Matching our animals to adopters:
What are you looking for in a pet? (What types of behavior)
_____________________________________________________________
_____________________________________________________________
References:
Veterinarian
Name _________________________Phone: __________________
Address ________________________________________________
Personal references (2 people not related to you)
Name __________________________ Phone __________________
Name __________________________ Phone __________________
I hereby certify that the above information provided on this form is true and
accurate. Falsification on this form will be grounds for adoption denial. If, for
any reason, I cannot keep the animal adopted from Center Valley Animal
Rescue, the animal will be returned to Center Valley Animal Rescue.
Signature:
Date:
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