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Thank you for your interest in our low-cost rabbit spay and neuter clinics.

Submitting this form does not guarantee an appointment or a place in an upcoming clinic. Applications are not approved strictly on a first-come, first-served basis. Because clinic space and funding are limited, requests will be reviewed and prioritized according to each rabbit’s individual circumstances and level of need.

We will contact you if an appropriate clinic opportunity becomes available. Please do not delay necessary veterinary care while waiting to hear from us. Clinic demands will be high, to stay updated on current clinics please subscribe to our newsletter.

OWNER/GUARDIAN INFORMATION

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Are you at least 18 years or older?

HOUSEHOLD INFORMATION

How many rabbits currently live in your household?

How many rabbits are you requesting spay or neuter assistance for?

Are any unaltered male and female rabbits currently housed together or able to have contact with one another?

Yes

Unsure

Is there a current or possible pregnancy?

Yes

Unsure

Have any of your rabbits recently had a litter? How long ago?

Yes

Unsure

Please provide the date of birth and number of babies and how old:

Are the rabbits housed indoors, outdoors, or both?

Indoors only

Outdoors only

Both indoors and outdoors

Rabbit(s) Information

Rabbit(s) name:

Sex:

Age or estimated age:

Breed or best estimate:

Approximate weight:

Is this rabbit currently housed with another rabbit?

Yes

Please list the other rabbit’s name, sex, and spay/neuter status:

Has this rabbit ever been examined by a veterinarian?

Yes

Unsure

Does this rabbit have an established veterinarian?

Yes

Please provide the clinic’s name:

Does this rabbit have any known medical conditions, disabilities, previous surgeries, or ongoing medications

If you selected any symptoms, please explain:

Has a veterinarian recommended that this rabbit be spayed or neutered for a medical reason?

Yes

Please explain and include the veterinarian’s recommendation, if available:

Has this rabbit previously been scheduled for or denied surgery?

Yes

Is this rabbit vaccinated against RHDV2?

Yes and currently up to date

Previously vaccinated but overdue

Unsure

Is this rabbit microchipped?

Yes

Unsure

ASSISTANCE AND SCHEDULING

What has prevented you from having your rabbit spayed or neutered previously?

Would you be willing to accept a short-notice appointment if there is a cancellation or we need to fill space for a clinic?

Yes

YOUR STORY

Please tell us more about your circumstances, your rabbit or rabbits, and why low-cost spay or neuter assistance would be helpful to your family. Include any information that may help us understand the urgency of your request.

Is there anything else you would like us to know?

ACKNOWLEDGMENTS

Please check each box before submitting:

* I understand that submitting this form does not guarantee financial assistance or an appointment.

* I understand that requests are not approved strictly in the order they are received and may be prioritized according to individual circumstances and need.

* I understand that this form is not a substitute for veterinary care or emergency medical treatment.

* I understand that final surgical eligibility will be determined by the participating veterinarian.

* I understand that additional examinations, testing, vaccinations, medications, or treatment may be recommended or required and may not be included in the clinic fee.

* I give permission to be contacted regarding this request and future rabbit-care clinic opportunities.