Contact Information First Name Last Name Email Address Phone Number Mailing Address Street Address Line 1 Street Address Line 2 City State Zip Code Date of Application How did you hear about us? RESIDENTIAL INFORMATION Single family home, apartment or townhouse? Would noise be an issue with your neighbors?YesNo FAMILY INFORMATION Please list your family members and their ages. Are there smokers in your home?YesNo Does anyone have allergies that could be a problem?YesNo Name and age of parrot’s primary caretaker? List all other pets (dogs, cats, birds, exotics or other animals) in your home. Type of parrot (parakeets, cockatiels and lovebirds are also parrots) that most interests you and why? Has your family owned a parrot before? When and what species? RELATIONSHIP GOALS On a scale of 1-5, with 1 being “I alone Will work with the bird” and 5 being “invested”, how invested are the other household members in the caring for and training of the bird(s)? On a scale of 1-5, with 1 being not very important and 5 being very important, how important is being able to pet your bird appropriately? Describe appropriately. On a scale of 1-5, with 1 being not very important and 5 being very important, how important is it to you that your bird step up onto your arm or hand? Would you be okay with your Bird stepping to a perch? Please choose one of the following options and write in the adjacent box: Noise doesn't bother me at all, I'm okay with most noises or I'd need to re-home a bird I found to be loud. How many hours per day will you be home during waking hours (dawn until dusk) with your bird? DIETARY INFORMATION What is the best diet for a parrot? Please be specific. VET/HEALTH INFORMATION Do you already have an avian vet? Who is it? If you have a parrot, when was his last appointment and what was it for? Adopters, do you agree to take this parrot for regular check-ups with blood work? YesNo Are you aware that some cookware, plants and cleaning materials are toxic to birds? YesNo HOUSING INFORMATION Describe the location of the parrot’s cage. What room will it be in? Where in the room will the cage be placed? What will the cage contain (perches, toys)? What other parrots will be in the same room? Describe how much mobility the parrot will have. Will it leave its cage? Go to other rooms? Eat with the family? Have a play gym? Provide examples of how parrots are different than other pets, and what you can do to meet these needs? INFORMATION ABOUT YOUR MOTIVATION, EXPECTATIONS & CONTINUING EDUCATION: Caring for a parrot is expensive. Can you name some of the costs? What is your monthly budget for parrot care (food, toys, vet visits)? Learning about a parrot’s nature and how to provide the best care in captivity can make a big difference in the success of a human/parrot relationship. What are your plans for staying current and informed on avian care? Do you intend to breed this parrot? INFORMATION ABOUT YOUR COOPERATION & INVOLVEMENT WITH COMPANION PARROTS RE-HOMED: Are you willing to attend Other Companion Parrots Re-Homed educational seminars? How do you feel about a virtual home visit from one of our representatives, prior to adoption? This allows us to work together to answer any questions you may have and point out potential hazards to help required for the adoption process. Are you willing to pay an adoption fee? This is the only way that we can sustain our program services. See the last page for our standard fees. YesNo It is very likely that even an adopted parrot will need another home in the future, as they live a long time and our lives often change unexpectedly. All parrots remain under the legal guardianship and protection of Companion Parrots Re-Homed, so if an adopted parrot needs a home after yours, you must contact Companion Parrots Re-Homed so that we can find the parrot’s next new home. Do you understand and agree to this? YesNo Include any other information you consider important for us to know, so that we can work together to help each parrot find the best new home: Thank you! We look forward to working together to make a better life for a parrot-in-need. By signing this application you indicate that you understand the adoption and quarantine process and agree to comply with it. Signature: Date: Acknowledgements Please read the following statements carefully and check the box provided on the left that you understand and agree to these terms: I am aware that all adopted birds remain under CPR’s legal ownership, and that if your adopted bird needs another home, I am to contact CPR immediately to discuss placement. I am aware that I will sign an adoption contract stating that I agree not to take my bird outside unrestrained (must be in a carrier or on a harness). I am aware that I will sign an adoption contract stating that I agree not to allow my bird to interact with any other pets in my home other than birds of similar size. I am aware that Teflon cookware (PTFE/PFOA), aerosols, and air fresheners can be deadly to parrots and must be removed from my home by my home visit.
