Cherished Wings Parrot and Bird Rescue Inc.

 Adoption Application

All of the information you provide will be held in strict confidence. Owning a bird is serious responsibility. Our policy is to ensure that all potential adopters are aware of this responsibility and are financially and physically capable of accepting it. Please answer all the questions and feel free to explain any answers and / or comments. If a question does not apply write N/A. If a question is left blank, the application will not be considered. This application is designed to aid all parties in the decision-making process, as we are seeking the best family for each bird and the best bird for each family…..   

Name :_______________________________________________________

Phone:_______________________________________________________

Address:______________________________________________________________

Email:________________________________________________________________

Age:___________

How many adults reside at this address?___________

Do you live in a house?_____ Apartment_____ Condominium ________Other______

Do you own or rent?__________

Do you have children?  Yes     No    

If so, what ages are your children ______________

Will your children be playing an active roll in the care for a new bird?  Yes   No

Do you own a parrot or bird at the present time? If so what species and how long have you had your bird? If not, where is your bird now and why? ___________________________________________________________________________________________________________________________________________

Are you breeding birds? Yes No

Have you ever bred parrots or birds? Yes No

 Are you looking for a parrot or bird to use in your breeding program? Yes No

 What species of parrot or bird are you interested in adopting?_____________________

What other pets do you own? Please check all that apply.

Dog (s)_______                           Hamster (s)_____________

Cat (s)________                           Gerbil (s)   ______________

Reptile (s)_________                   Guinea pig (s)____________

Ferret (s)__________                    Rabbit (s)_______________

Fish______________                   Other__________________

If you own a cat is he/she de-clawed? Yes _____No____________
 

Do you have a Veterinarian?     Yes     No     If so please provide his/her

name ,number and address:
_____________________________________________________________________________

_____________________________________________________________________________

Does anyone in your home smoke?  Yes      No

Do you use any air fresheners, carpet powder etc?    Yes    No

Are you or anyone in your household home during the day?      Yes    No

If not, what would your schedule be during the week and on the weekends?

__________________________________________________________________________________________________________________________________________________________

Do you have someone to care for your parrot or bird when you go away on vacation?

Yes      No

If you don’t have anyone what will you do with your parrot or bird?

____________________________________________________________________________-

How much time approximately would you be able to interact with a parrot or bird each day? Please check one:

15 min.-1/2 hour_________

½ hour—1 hour__________

1 hour ---2 hours _________

2 hours or more_________

Would your new parrot or bird be considered part of the family?   Yes   No

Will your bird be allowed to exercise out of his/her cage each day?   Yes    No

In what room of your home are you considering placing your parrot or bird’s cage?

Living room_________           Family room___________

Dining room_________           Kitchen   _____________

Bedroom ___________          Other ________________

Will you be having your parrot or birds wings clipped?   Yes      No

Have you ever trimmed a parrot or birds wings before?   Yes     No

Please be aware that we at Cherished Wings will not knowingly place a parrot or bird in a home that has been known to pluck his/her feathers or has an aggressive personality which could possibly injure someone without notifying you first. It is, however, important to realize that parrots and birds are capable of biting and can do so at some point if frightened or mishandled. Fear especially will trigger a bite reaction. We at Cherished Wings cannot be held accountable for any bites that may be inflicted upon anyone by an adopted parrot or bird as will as any damage that the parrot or bird may cause to ones home. Parrots especially can be noisy and will sound off several times a day. This is the most common in the early morning and evening hours as well as throughout the day. Some species of parrots and birds are noted more than others for doing so. This is natural behavior in which a bird communicates within the flock. You will have to determine your tolerance level regarding squawking and noise as some are louder than others. From the list below please check off in each category the level in which you can endure.

 

Noise level   Low___________                 Dependency    Low _____________

                   Med_________                                        Med ___________

                   High_________                                       High____________

Squawking   Low_______

                    Med ________                             None of the above concern me __________

                    High _________

You may be expected to visit 2-3 times with the bird before the adoption is complete. Are you willing to do this?     Yes     No

Are you aware that Cherished Wings may require 2 home visits after taking your bird home?   Yes        No

I understand that if I have any questions or concerns regarding my bird that I am to call  Cherished Wings     Yes     No

I understand that if at any time I can no longer care for my bird that he/she may not be sold or  given to a pet store.    Yes     No

I may give the bird to another family member or friend after notifying Cherished Wings first.

If the bird comes back to Cherished Wings there will be reimbursement equal to the condition of the bird minus 10 to 20% after it is re-adopted.

Will you sign a legal contract indicating this?    Yes     No

Where you made aware that there will be an adoption fee charge for each bird,  Yes    No

I understand that Cherished Wings is not responsible for any damages that these birds may inflict upon me or my home.   Yes     No

Please provide 3 references ( non-family members) 

1. References/phone number:  _______________________________________

2. References/phone number:  _______________________________________

3. References: /phone number: _______________________________________

****NOTE**** upon signing this document it becomes a legal contract that you fully understand.

Signature:__________________________________

Witness:____________________________________

Date: _______________________________________

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