REGISTRATION FORM
Please submit this form to let us know of your interest in either adopting a parrot or placing your parrot with us for adoption. All information is kept entirely confidential. You will be contacted soon by one of our representatives if we can immediately assist you. Otherwise, you will be placed in our database for future reference.
(Please note: this service is available for persons in Western Washington and Western Oregon only)

PART ONE: (All users)

YOUR NAME:

YOUR INTEREST:
Adopt A Parrot         Place My Parrot For Adoption

YOUR AGE: (required to use this form)

E-MAIL ADDRESS: (required to use this form)

MAILING ADDRESS:

CITY:

STATE/PROVINCE:

ZIP/POSTAL CODE:

COUNTRY:

PHONE:

FAX:

PART TWO: (For those seeking a parrot only. If you wish to request placement of your bird with us for adoption, continue to Part Three)

Why do you want a parrot?

What experience do you have with parrots?

In priority order, list the species of parrots that you would be willing to consider adopting:

Would you consider adopting a bird that has some "issues"? Please check the boxes below that you might consider:
Feather Picker (plucker)
Loud
Sometimes Bites
Not Very Tame
Older Bird
Injured or Deformed
One-Person Bird

List the members of your family and their ages:

What type of setting do you have for the parrot? (i.e. house/apartment, size of house, room where parrot will be kept, etc.)

Do you own or rent your home?
Own         Rent

List and describe other birds you have in your household:

What other (non-bird) pets do you have?

Are you willing to allow a home inspection?

Are you willing to contribute up to $300 to PSPR (depending upon species and individual) to adopt a parrot? (This fee helps us continue our service)
Yes         No

(CONTINUE ON TO PART FOUR)

PART THREE: (For those seeking to place their parrot with us for adoption)

PARROT'S NAME:

PARROT'S SPECIES:

PARROT'S AGE:

LEG BAND NUMBER:

PARROT'S SEX:

How was sex determined?
Surgical Sexing         DNA Sexing         Stated by Previous Owner

Why do you wish to give up your parrot?

Please provide as much of the background and history of the parrot as possible:

How long have you had the parrot?

What type of setting has the parrot been living in (i.e. house/apartment, bird room, other birds, other pets, children, window to look out of, etc.)?

Is the parrot bonded to any person or other bird in your household?

Please provide a description of the general health and status of the parrot:

Are the bird's wings clipped, or is it a house-flyer?:

Please provide a description of the parrot's personality and disposition:

Does the parrot talk?

Does the parrot have any bad habits (i.e. plucking, biting, screaming, finicky eater, unfriendly behavior, etc.)?

What does the parrot's diet consist of?

Who is the parrot's veterinarian?

Has the parrot been exposed to any type of illness or disease?

Do you have documentation of recent vet visits?

What is your time frame for giving up your parrot?
Urgent/ASAP         Fairly Soon         No Rush

Is a cage available for the bird? Please describe:

Can you send us photos of your bird?
(Please e-mail digital photos to rse@rsenter.com or mail prints to: PSPR, P.O. Box 496, Gig Harbor, WA 98335... be sure to send along the bird's name and species with your photos)

Are you willing to contribute $70 for PSPR to assume custody of your parrot for the purpose of future out-placement? (This fee helps pay for health checkup and board while at our facility)
Yes         No

How Did You Find Out About Us?
Other Way You Found Us:

PART FOUR: (For all users: Press the button below to send your registration to PSPR.)


Please press button only once, and wait for form to process.

THANKS FOR YOUR SUPPORT!