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?______________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
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