Parrot Bio Relinquishment Form

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Date:

Are you the owner of this Parrot?

If Other: please tell us

Would be considered the "Custodian" -If So, What is your relationship to the owner?

Other:

What it your relationship to this parrot?

If you’re the owner, caretaker, or custodian of this parrot complete the section below:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Do you use well water at this location?

Yes
No
Bottled water
Other

Other:

Phone Number:

How would you like us to contact you?

Landline
Cell Phone
Text Message
Other

Other:

Your Email Address

Parrot Owner's Name

First

Last

Parrots Name

Breed of Parrot

Sex of Parrot

Male
Female
Unknown
Other

Other:

Sex of the parrot determined by:

Surgical
DNA
Has laid eggs in the past
Unknown

Is your Parrot hand tame?

Other:

Does this parrot prefer right handed or left handed for stepping up?

Other:

Does this parrot prefer to step forward or step backwards?

Other:

Does your parrot have a leg band?

Yes
No
Other

Other:

Does he or she prefer men or women?

Other:

Please provide a brief description of the primary handler (age, hair color, etc.)

If this this parrot like children, which gender?

Boys
Girls
Unknown
Other

Other:

What ages can handle this parrot?

5-10
11-15
16-19
Other

Other:

Please provide any relevent information on children ages, hair color, and any additional information

Where did you originally acquire this parrot? Please provide detailed information:

What was the age of the parrot when you took him or her in?

Age of the parrot now?

Does your parrot have a microchip?

Yes
No
Unknown

What is the ID number?

Was your parrot previously in a breeding program?

Yes
No
Unknown
Other

Other:

Is he or she feather plucked?

Other:

Please explain where and the possible reasons why this feather plucking started.:

Does he or she become nippy?

Other:

Who or what provokes them to bite?

Is there anything special that you want us to know about your parrot? Please give us details.

If you would like you can upload any images of your Parrot up to 20MB.

Drag & Drop Files, Choose Files to Upload

How often do you take your parrot to the vet?

Other:

When was your parrots’ last veterinarian visit?

What was the reason for this visit?

Avian Vet’s Name:

First

Last

Clinic Name:

Clinic Address:

Address Line 1

Address Line 2

City

State

Zip Code

Clinic Phone Number:

Clinic E-mail:

Describe your parrots overall current condition:

Does this parrot require special grooming?

Beak
Nails/Wing Clipping
None
Other

Other:

Is this parrot fully flighted?

Other:

Has your parrot ever sustained any injuries?

Yes
No
Unknown
Other

Other:

Please describe the injury:

Has your bird ever been treated for any injuries or diseases?

Yes
No
Unknown
Other

Other:

Please explain the injury or disease, and how it was treated:

Has your bird ever been given any medications?

Yes
No
Unknown
Other

Other:

Please list medications reason(s) for medication:

Has your bird ever been on herbal or other alternative therapies?

Yes
No
Unknown
Other

Please describe:

Does your bird have any medical/physical condition that requires reoccurring treatment and/or a specialized perch or caging or play area?

Yes
No
Unknown

Please describe:

Have any parrots or any birds in your care fallen ill or died in the past?

Yes
No
Unknown
Other

Other:

Was a necropsy preformed on any deceased parrot?

Yes
No
Unknown
Other

Other:

Has this parrot had any behavioral issues currently or in the past?

Other:

Has this parrot had any additional or special types of behavioral issues/currently or in the past? If so, please list them:

What time of day does this parrot cry out or scream, and do you know what provokes him or her to do so?

How do you discipline your parrot?

Other:

When do you need to discipline this parrot?

Does the parrot have any special, obvious identifying marks?

Yes
No
Unknown
Other

Other:

Please list the identifying marks:

What gender, hair color, and age does the primary handler have?

Please let us know if this parrot likes or dislikes children. If s/he dislikes children, please list the age/hair color of the children this parrot dislikes:

If this parrot prefers a man or a women or both or all people. Please give us a detailed description. hair /color/ length age groups, and any additional information:

Has he or she been in a home with other animals?

Other:

Please give us a full description of other animals that this parrot has been around. Cats dogs and their reactions and interactions:

Does this parrot have strong dislikes?

Other:

Does this parrot mimic, talk, or know any words?

Other:

If he or she swears or mimics any words/ sounds or sentences; please enter them below

Does he or she sing songs?

Other:

What songs does it sing or whistle?

Does the parrot like music?

Yes
No
Unknown
Other

Other:

Please list the different types of music that the parrot is accustomed to:

Does the parrot like television?

Yes
No
Unknown

What types of programs?

What kind of toys does he or she like?

Other:

Has the Parrot lived in a household with cigarette/cigar smokers? (Cigarettes, Cigar, other):

Other:

Has the Parrot been outside the home on overnight trips?

Other:

How does he or she react to outsiders?

Other:

Does the Parrot get car sick?

Yes
No
Unknown
Other

Other:

Does this parrot like baths?

Other:

How do you bathe your parrot?

Other:

How often does he or she take a shower?

Other:

What type of primary seed does s/he like?

Other:

Do you hand feed your parrots treats?

Other:

What are his or her favorite table foods or treats?

What is the parrot's favorite fruits/veggies?

Served warm or cold?

Does the Parrot have any strong food favorites or dislikes?

Describe your Parrot’s current daily diet:

List the foods your bird currently eats, including specific food names and brands:

Seed Brands:

Any Pellets:

Nuts/ Unshelled/shelled:

Special favorite Treats:

Favorite cooked foods:

Favorite fruits and Vegetables:

Favorite table foods:

Favorite foods:

Will the Parrot stay on a perch or cage top if left alone?

Yes
No
Unknown

Is the parrot a cage escape artist?

Yes
No
Unknown

Padlock or link needed?

Yes
No
Unknown
Other

Other:

Will the parrot it come out of its cage on your hand?

Other:

Does the Parrot know the "Step up" command?

Other:

If not; how does the Parrot get in and out of its cage?

Daily morning routine:

Daily afternoon routine

Daily evening routine

Do you cover the cage at night?

Yes
No
Unknown
Other

Other:

Describe the type of blanket you use:

What type of laundry detergent do you use / If scented, name brand

Can you donate the parrots security blanket?

Yes
No
Unknown
Other

Other:

Type and number of perches in cage:

Type and number of toys inside or outside of cage:

In what room was the cage located?

In the cage area, how was traffic flow?

Other:

Any animals free roaming?

Yes
No
Unknown
Other

Other:

How many hours a day is the bird usually left alone daily?

Other:

How many hours a day is the bird usually out of its cage?

Is the Parrot allowed to freely roam when out of its cage?

Yes
No
Unknown
Other

Other:

Is he or she supervised when out of its cage?

Yes
No
Unknown
Other

Other:

For how long?

Routine:

How long if special routine?

Has the parrot ever bonded with another bird?

Yes
No
Unknown
Other

Other:

What breed and sex of other bird?

Is the parrot stick trained?

Yes
No
Unknown
Other

Other:

Is the parrot afraid of a training stick?

Yes
No
Unknown
Other

Other:

Do you know why?

Does the parrot pluck or over preen?

Yes
No
Unknown
Other

Other:

Do you know of any triggers for this type of behavior?

What steps have you taken to modify this behavior?

Is this parrot used to being toweled?

Yes
No
Unknown
Other

Other:

Has this bird been allowed on shoulders?

Yes
No
Unknown
Other

Other:

When did you first get this parrot?

Do you know who this parrots prior owners were?

Yes
No
Unknown
Other

Other:

Why did they need to re-home this bird to you?

Do you know how long the previous owners had this parrot?

Why do you need to place this bird up for adoption?

Is there anything else you would like a new owner to know about this parrot?

Items with bird (Toys, Perches, accessories)"

Cage description and dimensions:

What is the exact location of each feed bowl - As in the water bowel is located & the seed or pellet bowl is located, treats etc...

If you have a document with notes or a file document. You May upload it here.

Drag & Drop Files, Choose Files to Upload

If possible, please upload a photo of cage(s)

Drag & Drop Files, Choose Files to Upload

If possible; Please Upload any additional photos of your parrot(s) cage or parrot

Drag & Drop Files, Choose Files to Upload

If possible; Please Upload any photo of your parrot With cage(s)

Drag & Drop Files, Choose Files to Upload

Would you like to be in contact with the new adopter?

Other:

Full Name

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Type of Phone

Cell phone
Landline
Message #
Other

Other:

Any additional important or notes information that you would like the new adopor to know?

Would you like to be in contact with the new adopter?

Yes,By Email only
Yes, By phone & Email
Undecided
No, not necessary

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