Surrender Information Sheet

Please print this form and bring it with you filled in when you bring a bird to us or email prior to arrival or pickup(KeokukBirds@msn.com}. It will help make the new home much more comfortable and the bird happier in it.

SOUTH EAST IOWA PARROT RESCUE 3554 270TH Avenue Keokuk, IA 52632

Bird Information

Date: ________________

1. Bird's Name: _____________________________________

2 Species: _________________________________________

3. Age: _______________

Date of Birth: ______________________

4. Gender [ ] Male [ ] Female [ ] Unknown

5. Do you know the bird's weight? _________

4. Previous medical issues if any: _____________________________________________________

5. Current medical issues if any: _____________________________________________________

6. Veterinarian used: _______________________________________________

7. Food habits preferences/dislikes: _________________________________________________

8. Bathing habits (spray? bathe itself? frequency?): ___________________________________

9. History with other birds: _________________________________________________________

10. Sleeping habits (bedtime? covered? night frights?) _________________________________

11. Likes and dislikes (gender preference in people, Favorite toys): ____________________________________________________________________________

12 [ ] Flighted? [ ] Has ever flown? [ ] Wings clipped?

Owner information:

Name:________________________________________

Address: ______________________________State:____ Phone:____________________

Email:_______________________________________________

Where bird was purchased or adopted? _______________________________________________

How long has bird lived with you? ____________________________________________________

Number of previous owners, if known:_______

Reason for surrendering bird:__________________________________________________________________

WE WILL NOT BROKER THE SALE OF A BIRD OR, NOR WILL WE PAY FOR A BIRD.

A few things to be aware of:
1. We seldom place birds with smokers. This includes people who smoke only outside, at work, in the car, or anywhere.

2. We never ship birds anywhere.

3. We never place a bird with someone we haven't met, interviewed, and visited with here, and/or in their home.

Bird Links

South East Iowa Parrot Rescue
Placing a Bird with Us
Adoption Application
Adoption Agreement
Available for Adoption
Feed the Birds
Contact Us

Email: keokukbirds@msn.com