ADOPTION APPLICATION

ADOPTION APPLICATION
Date: _____________________
Name: _______________________________________________________________Age:_______________
Address: ________________________________________________________________________________
City: ______________________________________ State: _____________ Zip: ______________________
Phone: ___________________________________ Cell: __________________________________________
E-Mail: __________________________________________________________________________________
Married:____
Children:
Single:____
Yes:____
Other Pets or Animals:
Smoker?
No:____
Yes:____
Yes:____
No: ____
Ages: ____________________________________
No:____
If Yes, explain: ___________________________________________________________________________
Living Situation:
Own:____
Rent:____
Employment:
Full-time:____
House:____
Part-time:____
Condo:____
At Home:____
Apartment:____
Extended Travel:____
Employer:________________________________________________________________________________
Address:_________________________________________________________________________________
City: ________________________________________________ State:________ Zip: __________________
Phone: ______________________________________________
Would you be willing to let a hospital representative conduct a
Pre-adoption home visit?
Yes:____
No:____
Would you be willing to let a hospital representative conduct
Post-adoption home visits?
Yes:____ No:____
Would you consider providing temporary foster care to a parrot?
Yes:____
No:____
Would you be willing to adopt a noisy parrot?
Yes:____
No:____
Would you be willing to adopt a wild or untamed parrot?
Yes:____
No:____
Would you be willing to adopt a bonded pair of birds?
Yes:____
No:____
Would you be willing to attend an educational local parrot club meeting 3-4 times anually?
Yes:____
No:____
Please detail your previous parrot care experience including types of birds, how many years, nature of the
relationship and where the bird is now:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Please provide details regarding the diet you plan to feed your parrot:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Explain what kind of living arrangements you have planned for your parrot:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What kinds of enrichments will you be able to provide regularly for your parrot?_________________________
________________________________________________________________________________________
________________________________________________________________________________________
How much out-of-cage time will your parrot have each day?
________________________________________________________________________________________
________________________________________________________________________________________
How much one-on-one attention or socialization will your parrot have each day?
________________________________________________________________________________________
________________________________________________________________________________________
If you have cats, dogs or children, how do you plan to keep your parrot safe from harm?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If your parrot becomes aggressive toward you, your partner, your children or other household animals, how do
you plan to deal with the problem?____________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If your bird vocalizes or screams excessively, how do you plan to address this?
_________________________
________________________________________________________________________________________
________________________________________________________________________________________
Are you willing to work through issues of territoriality, destructiveness or seasonal aggression related to
reproductive cycles? How?__________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If you travel or vacation periodically, what arrangements will you make for your parrot?
________________________________________________________________________________________
________________________________________________________________________________________
Will you be bringing your bird to a specialty veterinarian for annual preventative wellness exams? _________
If your parrot becomes ill or injured are you financially capable of addressing the cost of specialty veterinary
care? ______________________
Please provide the information about your avian veterinarian:
Vet’s Name: _____________________________________________________________________________
Clinic Name: _____________________________________________________________________________
Clinic Address: ___________________________________________________________________________
City: ____________________________________________________State: _______ Zip: _______________
Are you aware of the dangers of non-stick cookware in the presence of birds?
Yes:____
No:____
Do you currently have non-stick cookware products in your home?
Yes:____
No:____
If yes, are you willing to replace all non-stick cookware products?
Yes:____
No:____
Do you or does anyone else smoke inside the home?
Yes:____
No:____
Do You plan to clip your birds wings?
Yes:____
No:____
If yes, why?______________________________________________________________________________
________________________________________________________________________________________
If no, explain how you plan to ensure your parrot does not escape:___________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Are you aware of the physical and psychological and health benefits of flight?
Yes:____
No:____
Are you aware of the potential long life-span of parrots?
Yes:____
No:____
Are you prepared for the potential behavior issues that can occur in birds when a new baby (human) is brought
into the home? And if yes, what is your plan?
________________________________________________________________________________________
________________________________________________________________________________________
What kinds of arrangements are you prepared to make for the care of your parrot when you become too old to
provide care, if you become sick or disabled, or if you die unexpectedly?______________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Why have you chosen to pursue a parrot as a companion?_________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What species of parrot are you most interested in and why?________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Why have you chosen to pursue adoption rather than purchase a parrot?______________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________