Today's Date
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MM
DD
YYYY
Bird's Name
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Species
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Age (or best guess)
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Sex (if known)
Current Weight
Previous Medical Issues
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Current Medical Issues
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Veterinarian
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Does anybody in the home smoke?
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Diet and Preferences-please be specific.
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Bathing Habits (spray, bowl, shower)
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History with Other Birds
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Sleeping Habits (time, covered?, night frights?)
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Likes and Dislikes (including gender preference)
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Personality, preferences, vocalizations, activity level, or anything else you would like us to know. This helps us best make your bird comfortable at the rescue and create a routine that they like.
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Flighted? Ever flown?
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Do they come with their cage?
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Your Name
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First Name
Last Name
Email
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Where was bird purchased/acquired?
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How long has bird lived with you?
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Number of previous owners
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Reason for surrendering
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Would you like to be contacted by the adopters? We cannot promise any communication, but if you wish, we can give your information to the new owners.
