Midwest Avian Adoption & Rescue Services, Inc. (MAARS) - Bird adoption, sanctuary, rescue, and care education services for parrots and other captive exotic 'pet' birds. Forms

P.O. Box 821 · Stillwater, MN 55082

Phone: 651-275-0568 · Fax: 651-275-0457

Captive Bird Rescue, Adoption, Sanctuary & Care Education

Forms

Surrender Form

IMPORTANT NOTICE: MAARS currently has a 60–90 day waiting list for all intakes except in true emergencies. If you are considering the surrender of a bird, please contact MAARS as soon as possible!

If you no longer feel you can properly care for your bird and are considering giving him/her up to MAARS for placement, please contact us first to discuss possible solutions and review your options.

If you have decided to surrender your bird for placement in a new situation, please fill out an Surrender Form in its entirety. The information you provide will help us to determine the needs of the bird and the most suitable environment for its future. You will be required to sign a legal copy of this form at the time of surrender.

Please feel free to contact us if you have any questions regarding MAARS or our captive bird surrender services.

Surrender Form Submittal Options

Online

Please fill out the Online Surrender Form below. When you are finished, submit the form for review by clicking on the Submit button at the bottom of the page. A MAARS representative will contact you shortly regarding your bird. You will be required to sign a legal copy of this form at the time of surrender.

Microsoft Word

Download a Microsoft Word (.doc) version of the Surrender Form. Complete the form in Word on your computer and e-mail it to surrender@maars.org as an attachment. You may also print the form, complete it by hand, and mail or fax it to us using the contact information at the top of this page. You will be required to sign a legal copy of this form at the time of surrender.

Adobe Acrobat

Download and print an Adobe Acrobat (.pdf) version of the Surrender Form. Please complete the form by hand and mail or fax it to us using the contact information at the top of this page. You will be required to sign a legal copy of this form at the time of surrender.

Online Surrender Form

We cannot process your application if any of the required fields marked with a * are left unanswered. Answers to questions NOT marked with a * are not required, but we appreciate you providing as much information as possible about your bird's needs and background to help us choose an appropriate new home for him/her.

Contact Information

Your Name*
Address*

City*
State*		Zip Code*
Home Phone*
Work Phone
Fax
E-mail*

Bird Information

Bird's Name*
Species*
Hatch Date
Age*
Sex (if known): Male Female How and when was the sex verified?
When did you acquire your bird?*
Where did you acquire your bird?* Pet store Breeder Animal shelter Bird club Private party Friend or family Gift Other:
Please provide contact information for your bird's breeder, pet shop, or previous caretaker:
Contact Name
Store/Business
Address

City
State		Zip Code
Phone
Fax

Veterinary Information

Please obtain complete vet records and mail, fax, or give them to MAARS when you surrender your bird.

Do you currently have an avian veterinarian?* Yes No If yes, please provide contact information:
Avian Vet's Name
Clinic Name
Clinic Address

City
State		Zip Code
Clinic Phone
Clinic Fax
How often do you take your bird to the vet?
When was your bird's last vet visit?
What was the reason for this visit?
Is your bird banded?* Yes No If yes, what is the band number(s)?
Is your bird micro-chipped?* Yes No If yes, what brand?
Is your bird DNA registered?* Yes No If yes, with whom?
Describe your bird's overall physical condition:*
Has your bird ever sustained any injuries? Yes No If yes, please describe:
Has your bird ever had any surgeries? Yes No If yes, please describe and give reason(s):
Has your bird ever been treated for any diseases? Yes No If yes, please describe:
Has your bird ever taken any medications? Yes No If yes, please list and give reason(s):
Has your bird ever been on herbal or other alternative therapies? Yes No If yes, please describe:
Does your bird have any medical/physical condition that requires treatment and/or a specialized caging/play area?* Yes No If yes, please describe:

Current Diet

Describe your bird's current daily diet:*

List the foods your bird currently eats, including specific food names and brands:

Seeds:

Pellets:

Nuts:

Treats:

Cooked Foods:

Fruits and Vegetables:

Table Foods:

Junk Foods:

Favorite Foods:

Do you use vitamin supplements? Yes No

If yes, how do you give them?

Routine Care

Who is your bird's primary caregiver?*

When you go on vacation, who cares for your pets?

Describe your bird's cage, including size, brand, and model (if known):*

Does the cage have a grate? Yes No

How many perches does the cage have?

What type of perches does your bird prefer?

How often do you clean the cage?

How do you disinfect the cage?

Does your bird use a separate sleeping cage? Yes No

If yes, please describe:

Describe your bird's favorite toys:

Describe your bird's playtime activities:

Describe your bird's sleeping habits, including bedtime, wake-up time, nap times, and hours of sleep each day:*

Does your bird ever have night frights? Yes No

Do you cover your bird's cage? Yes No

Describe your bird's bathing habits, including frequency, likes, and dislikes:*

Describe your bird's play area(s):

Is your bird destructive?* Yes No

Please explain:

How many hours a day does your bird spend outside the cage?*

(If 0, enter "None" or "Zero")

How many hours a day does your bird spend home alone?*

(If 0, enter "None" or "Zero")

Do you the radio, TV, or other audio/video on for your bird? Yes No

If yes, please describe:

Are there any other birds or pets in your home?* Yes No

If yes, please list:

Behavior

Is your bird hand tame?* Yes No

Please explain:

List other members in your household and describe how they interact with the bird:*

Who is your bird's favorite person?*

Does your bird like children?* Yes No

Please explain:

Does your bird like visitors in the home?* Yes No

Please explain:

Does your bird interact with other birds?* Yes No

If yes, please describe:

Does your bird have any known behavioral problems (e.g., screaming, plucking, chewing, biting, etc.)?* Yes No

If yes, please describe:

Has your bird ever seen a behaviorist?* Yes No

If yes, who, when, and what were the results?

List any changes within your household that may have contributed to the above behavioral problems:

Why are you considering placement of your bird with MAARS?*

Would assistance with education or behavior modification be a possibility as a means for you to keep your bird?* Yes No

Please explain:

How did you learn about MAARS?*

Acquisition Terms

You will be required to sign a legal copy of this form at the time of surrender.

I hereby authorize the release of ALL medical records pertaining to the above listed bird(s) to a representative of MAARS.*

Instructions:

I hereby donate to Midwest Avian Adoption & Rescue Services, Inc., the above listed bird(s) to be placed in the MAARS adoption program. I relinquish all claims to the above listed bird(s) and any future progeny.*

A copy of this document will be provided to the adopting party. If you wish MAARS to withhold your name and contact information, please check here.