Surrender Information Sheet

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 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 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