RHDV2 Vaccine Clinic
This form is not a guarantee of service, or a consent to medical procedures.

This form is to collect contact information for rabbit owners that are interested in getting their rabbits vaccinated with Eravac at a vaccine clinic organized by Bunnies Urgently Needing Shelter (BUNS) and local veterinarians (dates TBD).

By filling out this form, you consent to have BUNS contact you with further information about the vaccine clinic. This information may also be used to populate forms at the vaccine clinic.
Email address *
Name *
Best Phone Number *
Street Address *
City *
Zip Code *
Who is your current veterinarian? (If none, please enter "none") *
What is your veterinarian's phone number? (If no current vet, enter NA) *
How many rabbits do you need to get vaccinated? *
Optional: For each rabbit, please fill in the following information.
If you have more than 4 rabbits, we can collect rabbit information another way.
Rabbit 1 Name and Sex (e.g. "Fluffy, F")
Rabbit 1 Breed and color (ex. Dwarf, brown):
Rabbit 1 Other ID (microchip, tattoo, etc.):
Rabbit 2 Name and Sex (e.g. "Fluffy, F")
Rabbit 2 Breed and color (ex. Dwarf, brown):
Rabbit 2 Other ID (microchip, tattoo, etc.):
Rabbit 3 Name and Sex (e.g. "Fluffy, F")
Rabbit 3 Breed and color (ex. Dwarf, brown):
Rabbit 3 Other ID (microchip, tattoo, etc.):
Rabbit 4 Name and Sex (e.g. "Fluffy, F")
Rabbit 4 Breed and color (ex. Dwarf, brown):
Rabbit 4 Other ID (microchip, tattoo, etc.):
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