Spokane Area
Representative
Sarah Forbes
509-218-0051 425-269-6155
sarah@cockatielrelocation.org Ramona@cockatielrelocation.org
ADOPTIVE HOME
APPLICATION
*Please
fill out this application and either email it to us, or mail it to
*Filling
out form does not guarantee an adoption.
*The
birds welfare is our #1 priority. Our hope is, by answering honestly, we
can work together, to correct any issues that may need attention. We also want you to understand, that we will
always be there to help you with this adoption.
If you don’t know the answers to all of these questions, please let us
know, and we will help educate you more about birds, their care, before
completing the adoption.
1. Applicant’s Name:
2. Applicant’s Residence Address:
Please circle one: House or Apartment Rent or Own
If you rent do you have permission
from landlord for bird? Y or N
3. Applicant’s Phone Number: Best time to call?
4. Please list all of the people living in your
home. If children, please list ages;
5. Do you have any birds now? Y or N
If yes, what?
6. Have you ever owned birds, which are no
longer in your care? Y or N
If so, why are they no longer in
your care?
7. Please list all other animals also living in
the home;
8. Are all adults that live with you, aware that
you are interested in adopting a bird?
Y or N
9. Do you work?
Y or N
10. How many hours a day, will the bird be left unattended?
11. Would anyone living around the bird
smoke? Y or N
Smoking
outside is fine with me. If you are a smoker & bird is placed: ANY EVIDENCE OF SMOKING IN THE HOME, after
adoption, WILL RESULT IN THE IMMEDIATE REPOSSESION OF BIRD. We do continue to check.
12. Do you understand that we do not allow
any bird we place, to go to a home where cigarettes are smoked in the
house? Y or N
13. Will you be willing to take a bird with
behavioral problems? Y or N
14. If you travel who will take care of the bird?
15. Do you already have an avian vet? Y or N
16. What will you do, if you run into a
behavioral problem, that you cannot seem to
solve?
*We are
available 24 hours a day to help with health or behavior questions.
17. Are you aware that hook-bills have a normal
urge to chew wood? Y or N
*It is
imperative that wood toys be available, at all times, to avoid birds
destructive chewing.
18. All birds are expensive. They need lots of
attention & maintenance. Have you considered this? Y or N
19. Please explain what you are looking for in a
bird;
20. Do you understand that a home visit is required
before you will even be considered for an adoption? Y or N
21. Do you also understand a post adoption visit
is also required? Y or N
22. Please list a few signs of illness in a bird:
23. Please describe dangers in a household that a
bird might be exposed to in any house hold.
24. Where in the house will the bird’s cage be
located?
25. Vitamin deficiencies can be life threatening
to birds. It is very important that you provide a bird with a wide variety of
foods. What foods would you feed/provide to you bird?
26. What are some foods that are toxic to birds?
27. What size (in dimensions) will the cage be,
for the bird you are interested in?
28. May we see cage before adoption?
29. Why is it necessary to provide perches of
different diameter and texture perches?
30. List some household cleaners & plants that are
toxic.
31. Can you name items, in every household, that
many pose a danger from fumes to birds?
Please list at least five:
Due to a
bird’s very complex respiratory system, smoke of any type (even burnt food in
kitchen) is deadly to birds.
32. Have you ever been charged with Animal
Cruelty or Neglect of an Animal? Y or N
If yes, when, where, why?
If yes, were you convicted? Y or N
33. Can we ask how you heard of us?
Thank
you so much for considering adoption, and for your time!