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Rabbit History Form
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Rabbit Details
Name
Age (date of birth)
Sex
Male
Female
Is your rabbit spayed or neutered?
Date acquired
Source (pet shop, friend, breeder, etc)
Details of Other Pets
Do you have any other rabbits? If yes, please provide details (name, date acquired, source, any known illness)
Do you have any other pets? If yes, please provide details (species, date acquired, source, any known illness)
Indoor Rabbit Husbandry
Does your rabbit have access to the entire house? (If he/she is confined to one room, please provide details)
Is your rabbit kept in a cage indoors? If yes, please provide approximate dimensions
Please describe the bedding and litter used in the cage
Where does your rabbit urinate and defecate?
Do you provide full spectrum lighting – uva/b lights? If so when was it last changed?
Outdoor Rabbit Husbandry
Where is your rabbit’s hutch situated?
Are there any trees hanging over your rabbit’s hutch?
Is there shelter from predators?
Have you ever seen rats, mice, foxes, cats, or birds of prey in your garden? (If yes, please specify)
Please describe the vegetation in your garden
What type of litter do you use on the floor of your rabbits hutch?
Has your rabbit damaged any household items? If yes, please provide details (item, how and when it was damaged)
Food
Please describe your rabbit's diet (Include pellets, all snacks, treats and any food related item)
Has there been a recent change in diet? If yes, please specify
Are any of the following given to your rabbit?
Vitamins
Minerals
Medicines
Probiotics
Tonics
Water
Does your rabbit drink from a bowl or a sipper-bottle?
Have there been any changes in drinking habits with your rabbit?
Has the drinking increased or decreased as of late? If yes, when did you notice?
The Presenting Health Concern
Has your rabbit had any previous health issues? If yes, please provide details
Please describe your rabbit’s clinical symptoms
Does the skin and fur appear normal?
Has there been any excessive scratching?
Has there been any nasal or ocular discharge? If yes, please provide details
Has there been any odd positioning or loss of use of any limbs? If yes, please specify
Has there been any abnormal vocalization?
Is your rabbit’s nose twitching normally? If no, please specify
Are your rabbit’s droppings normal in appearance and size? If not, please provide details
Have you noticed any coprophagy (rabbit eats droppings)?
Does your rabbit spray urine? (If yes, what color is the urine and has this increased or decreased as of late?)
Does your rabbit thump?
Have you noticed any increases or decreases in thumping?
Any additional comments
Δ
Home
About Us
Location & Hours
Team
Associated Veterinary Specialists
Continuing Education
Community Involvement
Our Patients
Success Stories
Send Us Your Photos
Services
Medical Services
Surgery Services
Emergency Care
Specialty Services
Wellness and Preventative
Puppy and Kitten Exams & Vaccinations
Laser Procedures
Blood and Plasma Transfusions
Nutrition
Anesthetic Monitoring
Resources
Educational Articles
Educational Presentations
Pet Health Checker
Forms
Prescription & Food Refill
Referrals
Weight Loss Questionnaire
Feline Friendly
Exotic Care
Emergency
Emergency Procedures
Emergency Procedures – Dogs and Cats
Emergency Procedure For Your Pet Bird
Emergency Procedures For Your Reptile
Emergency Procedures – Small Mammals
Wildlife Emergency Procedures
Careers
Externship Opportunities