Bird Adoption Questionnaire

Name:_________________________________________________ FOR OFFICE USE:

Address:___________________________________ Apt. #:______ P#:_________________________
City:___________________________ Postal Code:_____________ A#:_________________________
Phone #:________________________________________________ Date: _______________________
Time: _______________________
E-mail:_________________________________________________

Why do I need to provide my personal information before meeting an animal?

We request that any potential adopters fill out initial information before meeting an animal, so that our
staff can better serve you and your needs. This information will help us place animals in new homes, and
we ask for your cooperation in the exciting process of bringing your new pet to you.

ABOUT YOU and YOUR HOME 15. What is the best diet for this bird? (check all that apply)
1. Please select the appropriate age category: □ Seed mix □ Veggies □ Pellets
□ Under 18 □ 18+ Optional: Age____
16. What is the best cage liner for your bird? (check all that apply)
2. What best describes your living environment? □ Newspaper □ Blank paper/newsprint
□ Townhome □ House □ Apartment/Condo □ Paper towel □ Other:___________________
Do you: □ Own □ Rent
17. Do you intend to clip your birds wings? □ Yes □ No
3. In your house, number of:
Adults(18+): ______ Children: _________ Ages: ________ 18. How much free-flight time will your bird have each day?
□10-20min □30-45min □1hr □2-4hrs □4+hrs
4. Are there other pets in your household? □ Yes □ No
19. How much time do you expect to spend actively socializing
5. Do you know how to introduce your pets to a bird? your bird each day?
□ Yes □ No □10-20min □30-45min □1hr □2-4hrs □4+hrs
6. Are you adopting a bird to bond to your current bird?
20. What enrichment opportunities will you provide?
□ Yes □ No
_____________________________________________________
7. Are there any allergy/asthma sufferers in your home?
□ Yes □ No 21. Do you intend to take your bird to a vet?
□ Yes □ No □ Only if sick
8. Does anyone ever smoke inside your home? □ Yes □ No
22. Do you currently have an avian vet? □ Yes □ No

PET CARE
23. How much do you estimate it will cost to care for this
9. Have you had birds before? □ Yes □ No
animal each year? (incl. vet care, food, toys, supplies, etc.)
□ Under $100 □ $100 - $250 □ $250 - $500
10. Were you the primary caregiver? □ Yes □ No
□ $500 - $1000 □ $1000+
11. Is your home prepared for this bird? □ Yes □ No
24. Are you financially prepared to care for this animal?
□ Yes □ No □ Unsure
12. Are you aware of the life expectancy of this species?
□ Yes □ No
25. Are you interested in and prepared for a bird with
13. Are you aware of the noise level of this species? current behavioural challenges? □ Yes □ No
□ Yes □ No
14. Do you currently have an enclosure meeting our 26. How would you address unwanted behaviour?
minimum size requirements? _____________________________________________________
□ Yes □ No □ Unsure
 TELL US WHAT YOU’RE LOOKING FOR
Age: □ Baby □ Young adult □ Adult □ Senior □ No preference
Size: □ Small □ Medium □ Large □ Extra Large □ No preference
Type/Species:

Personality:

IT IS VERY IMPORTANT FOR MY BIRD TO… (please check all that apply)
□ Be friendly with me □ Be low maintenance □ Be active/playful
□ Be friendly with visitors/family/friends □ Enjoy being held/pet □ Be beautiful/unique
□ Be friendly with children □ Be Intelligent □ Be inexpensive
□ Talk □ Be quiet □ Be quiet at night

WITH MY NEW BIRD, I WOULD LIKE TO… (please check all that apply)
□ Relax and cuddle □ Play together □ Have them play with children
□ Clicker train □ Watch them play with another bird/by themselves
□ Other:__________________________________________________________________________________________________

HOW FAMILIAR ARE YOU WITH THE FOLLOWING IN THIS SPECIES?

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Fearfulness/anxiety □ □ □ □ □
Destruction of property □ □ □ □ □
Creating messes in the house □ □ □ □ □
Biting □ □ □ □ □
Territorial behaviour □ □ □ □ □
Bonding birds □ □ □ □ □
Safety proofing for birds □ □ □ □ □
Screeching □ □ □ □ □
Unfriendly behaviour with some family members/visitors □ □ □ □ □
Unfriendly behaviour with other pets □ □ □ □ □

In order to keep you informed about important campaigns and to ask for support, we will from time to time telephone, email and send mail to
you. If you would like to receive phone calls, emails or mail please check this box □

Applicant signature:________________________________________ Date: ___________________________________

Thank you for completing this questionnaire.

The information provided will help us to find the best matches to your interests.