We understand that there may come a time where a life change, emergency situation, sudden allergy, behavioral, medical, or other problem, would cause you to have to give up your parrot. Making the decision to place your bird in our care, may be the hardest decision you will ever have to make. Rest assured that we are here to help you, and make the process as painless as possible.
Your bird will receive the very best care, medical attention, food, and love at The Tiki Room. He will live surrounded by humans and others of his kind, in a more natural environment with so much to do and explore! The Tiki Room changes daily, to keep a parrot's sharp mind entertained. Trees and plants are constantly rotated, moved, changed, or pruned. Toys, ropes, ladders, vines are moved around, changed, and added to.
When surrendering your bird, it will help us emmensly to know everything we can about them. By printing and filling out the form below, you will help us in finding the right home for your bird, or in deciding that permanent sanctuary would be a better fit. Also bringing the bird's own things (such as their cage, toys, favorite food, etc.) will help the bird adjust to his new surroundings, as well as helping us keep our costs down.
What to do BEFORE you bring the bird (and only after all attempts to rectify problems in order to keep the bird have failed, and placing the bird with our sanctuary is the only option):
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INTAKE INFORMATION FORM
Please print this form and bring it with you filled in when you bring a bird to us. It will help make the new home much more comfortable.
Intake Interview
date
1. Bird's Name and any used/familiar nicknames:
2 Species:
3. Age (Approximate is fine, but actual is best if you know it.):
4. Sex (If known, and please provide a copy of the surgecial/DNA sexing results for us to keep on file.):
5. Weight and general condition/behavior on intake (to be filled out by our volunteers.):
4. Previous medical issues if any:
5. Current medical issues if any (list ALL please. If your bird is ill with a communicable or easily transferrable illness, we may not be able to take them into our shelter for fear of contaminating our healthy birds. However, we do have several available foster homes that a sick bird could possibly be placed in. Please do not withold information! You could not only be hurting YOUR bird, but possibly MANY birds!):
6. Your avian vet (Name, address, and phone number. We WILL varify.):
7. Food and treat habits/preferences and likes/dislikes of foods:
8. Bathing habits (showers? spray? bathes itself? frequency?):
9. History with other birds, and other pets (dogs, cats, etc.):
10. Sleeping habits/routines (bedtime? covered? night frights or unusual fears?):
11. General likes and dislikes (gender preference in people, loud noises, etc.):
12. Is the bird flighted (fully feathered, not clipped? Has it ever flown?):
Owner information:
Name:
Address:
Email:
Where bird was purchased or adopted and when?
How long has bird lived with you?
Number of previous owners, if known:
Any traumatic, neglectful, abusive previous owner experiences, if known:
Does the bird have any unusual fears (towels, gloved hands, new toys, etc.), that you know of:
Reason for surrendering bird: (You may choose to leave this blank for personal reasons. However, if you are surrendering the bird due to a severe behavioral (biting, screaming, plucking, etc.) issue, it will help us to know this information so we may help rehabilitate your bird. If your bird has ever severely injured someone (adult or child) we need to know this so we don't inadvertantly put the bird in an unsuitable home. If you are surrendering the bird due to medical issues, we need to know the nature of the medical concern so that we can properly treat it. However, you do NOT need to tell us if you are surrendering due to an inability to pay for medical, or behavioral problems.):
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What you do when you bring the bird to us:
When you arrive you will be asked to fill out the following contract with our director, while a volunteer accesses your birds weight and general physical condition.
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SURRENDER AGREEMENT
The Tiki Room and ____________________________________ (hereafter "surrenderer") agree that the following bird:
_______________________________, a __________________________ is surrendered
under the following conditions:
1. Surrenderer states that the bird has no known diseases or disabilities other than
____________________________________.
2. Surrenderer states that they are legally in possession of the bird and have the right to place it, and that no other person has any legal or financial claim on the bird.
3. Surrenderer agrees that they have received no promises or inducements from The Tiki Room except those included in this agreement, and that they were not forced or coirsed into giving up their bird in any way.
4. Surrenderer agrees that they are voluntarily surrendering all claim to this bird, and all legal and financial interest in this bird to The Tiki Room.
5. The Tiki Room agrees that the bird will at no time be sold, traded, or in any other way disposed of for any profit or financial gain; nor will the bird be placed with any person who will use it for commercial breeding purposes; nor will The Tiki Room breed any bird, either for personal property or sale.
6. The Tiki Room agrees to maintain the bird in healthy and safe conditions, according to generally accepted standards. This shall include such veterinary care as may be necessary.
7. The Tiki Room agrees to place the bird only in such home as can provide adequate care, to include housing, diet, and veterinary care.
8. The Tiki Room and surrenderer agree to mutually release and absolve each other from any and all future claims on this particualr bird.
____________________________
The Tiki Room
________________________________
Surrenderer
address_____________________________
_____________________________
phone and email_____________________________
date________________
Lastly, do you wish to give any of your contact or other information to a potential adopter for future reference, or updates? If yes, please specify which information you'd like given.
