Wild Rabbit Care Intake Form
Please provide detailed information about the wild rabbit you are bringing in for care.
Full Name of Finder
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Date and Time Found
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location Where Rabbit Was Found
*
Estimated Age of Rabbit
*
Please Select
Neonate (eyes closed, no fur)
Juvenile (eyes open, some fur)
Subadult (smaller, active)
Adult (full size)
Unknown
Sex of Rabbit
Male
Female
Unknown
Physical Description (color, markings, size)
*
Condition at Intake (check all that apply)
*
Alert and active
Lethargic or weak
Visible injury (wound, fracture, etc.)
Bleeding
Orphaned (no mother present)
Parasites (fleas, ticks, etc.)
Other
Immediate Care Provided (if any)
Upload Photos of the Rabbit (if available)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Notes or Observations
Submit Intake
Should be Empty: