Owner First Name *
Owner Surname *
Owner Phone Number *
Rabbit Name *
Breed *
Age *
Gender * Male Female Unknown
Are they desexed? * Yes No Unsure
Is their Calicivirus vaccination up to date? * Yes No Unsure
Are they housed indoors or outdoors? * Indoors Outdoors Both
Describe their housing arrangements (free range, hutch, etc.) *
Are there any other rabbits/animals at home? If so, please list. *
Were any new pets introduced to the household recently? If so, were were they acquired from, and when? *
What is their diet? List all foods offered, including the amount. *
What treats do they receive? Include the amount and frequency of each. *
Is parasite prevention up to date? What was applied/administered, and when? *
Describe the problem, including when it started? *
Has there been a recent change in environment? *
Have you noticed any diarrhoea? If so, describe the frequency, and when it was first noticed. *
Have you noticed any breathing changes or sneezing? If so, describe the frequency, and when it was first noticed. *
Has there been a recent change in behaviour? If so, please describe. *
Has there been a recent change in thirst or appetite? If so, please describe. *
Please list any known health issues, allergies, medical problems, or long-term medications. *
Do you have any questions for the vet which haven't been mentioned in the above history questions?
