Pre-Surrender Questionnaire

Filing out and submitting this questionnaire assists us in preparing for your chinchilla's arrival, by knowing a little about what supplies and space will be needed to accommodate him or her, and if there are any special concerns.   If you will be surrendering more than two chinchillas, please submit the form a second time with the information of the remaining chins.  Since we rarely take in more than two chins from the same owner, we did not include additional chinchillas on this form.

 

Please!
Do NOT fill out this form unless you have contacted us via email regarding your situation and have received a reply from us directing you to do so!

 

Your Name (first and last, please):  

Your City and State:  

Your Email Address:   

Name of Chinchilla:  

Name of Second Chinchilla (if applicable):  

Age of Chinchilla:           Do not know

Age of Second Chinchilla (if applicable):           Do not know

Gender of Chinchilla:
Male
Female
Unsure

Gender of Second Chinchilla (if applicable):
Male
Female
Unsure

If you have a female, has she been in contact with an unneutered male in the past four months?     Yes     No

If you are surrendering more than one chinchilla, do they live in the same cage?     Yes     No

 

Have there been any health concerns in the past (chins are accepted regardless of health issues.  This information just helps us prepare for what is needed to better care for each individual chinchilla)?     Yes     No

If yes, please explain (please specify which chinchilla if more than one is being surrendered): 

 

What brand pellet food do you feed? 

Brand of Pellet Food if not listed above?:  

 

Will your chinchilla(s) be coming with a cage(s)?     Yes     No
If yes, please provide the following information:

First cage
Dimensions (in inches, please):   Length        Width        Height

Does this cage come apart or collapse for transport?:     Yes     No

If you know of a website that has a photo of this cage, please indicate it here: 

 

Second cage (if applicable)
Dimensions (in inches, please):   Length        Width        Height

Does this cage come apart or collapse for transport?:     Yes     No

If you know of a website that has a photo of this cage, please indicate it here: 

 

Please indicate any supplies that will be coming with your chinchilla(s):
Bath dust
Dust bath container
Hidey-hut (house)
Hay
Treats
Wheel
Hammock
Water bottle
Food dish
Supply of food (a small supply is required if your brand is not Kaytee Forti-Diet or Mazuri)

Please indicate any other items not listed above that may be of interest to us: 

 

Please briefly state why you are surrendering the chinchilla(s) to us for rehoming:

While we strive to get chinchillas into Second Chance Chins as quickly as possible, sometimes we have to restrict the number of incoming chinchillas due to space constraints.   If you have a situation that requires the chinchilla be surrendered immediately, please indicate so and explain.  If you have any further comments not provided for on this form, please use the box below for that purpose as well: