CRPS Adoption Form

Pet Bird/Parrot Adoption Application
What type of bird are you interested in adopting? (Species, name)*
Your name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Do you work?*

Full timePart timeRetiredDisabled
Names and ages of all permanent residents of your home (adults/children)*
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before & your adoption is approved, you will need to provide a vet's name)*
Vet name, address & phone number
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
Please list how many other pets are currently living in your home, including other birds, cats, dogs and reptiles. If none, please put N/A*
When will you be ready to adopt this bird?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
Do you or anyone in your home smoke?*

YesNo
Are you familiar with the species of bird you are interested in?*

YesNo
Who would be the primary caregiver for this bird?*

SelfSpouseOther, please specify:Other
If you answered no to the question above, please visit Google and do a bit of research so you can be prepared for your new family member!
Please list your experience with pet birds. E.g. parakeets, Cockatiels, conures, African Greys, Macaws, Cockatoos etc. *
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
If you rent, you must give the person you are adopting from a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
Birds are generally long lived and require a lifetime committment of good care to thrive. With this in mind, please make sure that any bird you are adopting will be a permanent resident.
If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children
Vet bills can be expensive. Some birds require regular beak, nail or feather trims and all require an annual well bird exam. How do you plan on paying these services? (IE: Pet health insurance)*
Do you have any additional comments, questions or concerns?*
Additional reference (if desired)
Are you willing to pay a small re-homing fee to the owner to cover any costs. e.g. vet, food, etc.? If so, what amount?*
If you are paying a rehoming fee, what is your method of payment?*

CashOther/None
Rescued birds can sometimes have initially unseen difficult behavior problems that will need time and patience to correct and the bird will need your love and understanding to get through these issues. By checking the box below, you understand the terms of this form and adoptee. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the Capital Region Parrot Society and explain your situation before taking the animal to a shelter, selling it or giving it away.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact me (the person you are adopting from) or any of the admins in the Adopt/Rehome network. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!
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Pet Bird/Parrot Adoption Application