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916-956-2153
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19084 Dayton Rd
Bend, OR 97703
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SCBR Adoption Application Form
admin
2023-12-05T17:26:59+00:00
Adoption Application Form
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Step
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In order to proceed with your application, please confirm that you are available to begin the interview process and adoption process within the 72-hour timeframe. The rescue organization has a tight timeline, and time spent on potential adopters who are not ready may result in a parrot losing its forever home to a potential adopter who is ready.
*
I Understand
How did you learn About us ?
Google Search
Adopt A Pet
Petfinder
Referred By Our Veterinarian
Facebook
Other
I/We understand Second Chance Bird Rescue will not ship any parrot. *Moreover, I/We understand that meet and greeting of adoptable parrots are Mandatory. I/We understand that we must live in Oregon or Washington State to adopt any parrot.
*
Confirm.
* To Confirm Again ...*Yes... I/ we are prepared to Meet a Parrot within 72 hours.
*
Confirm
Date / Time
Date
Time
I/We understand that we are required to drive to Bend Oregon, for our Mandatory meet and Greet of any available Parrot
*
Confirm.
** I/we understand if we have Not SELECTED A PARROT from the website, we will Not BE CONTACTED.**
*
Confirm
I/ we understand that we are only allowed to submit ONE application to adopt within 6 months of today's date. I/We understand if we don't select a parrot from the available list that we will NOT be contacted.
*
Confirm.
I / We understand that Second Chance Bird Rescue prefers to rehome our parrots primarily as companions for humans, not for companions for another parrot
*
Confirm
I / We understand that Second Chance Bird Rescue most likely will Not rehome a parrot in a home with children under the age of 18. *Unless specified in the description that the parrot is safe for a home with children.
*
Confirm
I / We understand that Second Chance Bird Rescue prefers to rehome our parrots in homes with 4 or less medium or large parrots or other inside animals
*
Confirm
I / We understand that Second Chance Bird Rescue -* PREFERS to rehome our parrots with adopters with the minimum of 1 year, proven medium or large parrot experience - Not mandatory - *Although preferable*
*
Confirm
I understand that I must be a minimum 26 years or older to apply to adopt. Also I understand that I must be one of the heads of the household.
Yes
No
What is your age range
*
26 to 30
31 to 35
36 to 46
46 to 56
56 to 66
56 to 66
Over 66 years of age
I/ We understand that Second Chance Bird Rescue will not place a parrot with anyone over the age of 65, with out having 2 confirmed Approved backup Parrot Guardians'.
*
Confirm
You're seeking a parrot for:
*
Myself
Spouse or Partner
Family member
Disabled Person
Companion for my parrot
Friend
For someone else
Breeder Bird
Who will be the primary caregiver for the parrot?
*
If this parrot is for a disabled person aware they aware that you are are applying for this parrot?
*
Yes
No
Name of other person:
First
Last
Phone number of the other person
If this parrot is for an disabled person. They must be aware of this adoption and must be present while filling out the application and our meet and greet process. Please confirm:
Confirm.
I / We understand that the person applying to adopt- MUST Be the person Submitting this Application or near you during submission;
*
Yes, I'm the one applying to adopt
I am applying for someone else
The adopter is disabled, unable to type
Most parrots only prefer a handler of a certain gender, please select what best fits the primary handler:
*
Man
Woman
Both
*Children over the age of 18
*Children under the age of 18
Other:
Your Name
*
First
Last
Name of Partner or Spouse
*
First
Last
Your physical Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Phone
*
Cell Phone
Email Address
*
Best time to call you?
*
Mornings
Afternoon
Evenings until 9pm
Anytime between 9am & 9pm
Other times entered below
What time is the best time to reach you
*
Are you the head of your household?
*
Yes
No
Shared
Type of home?
*
House
Apartment
Condo
Attached Mobile
Other
Do you own or rent?
*
Own
Rent month to month
Lease
Government Housing
Other
Are you aware that we cannot permit placing any large parrot into an apartment, duplex or condo
*
Yes
No
Do you use well water at your residence ?
*
Yes
No
Sometimes
How long have you lived at this residence?
*
Less then 6 months
1 year
2 to 4 years
5 years or longer
Other
Other:
* If less than 1 year at current residence. How long did you live at your previous address?
1 year
1 to 3 years
3 years or longer
Other
Other:
*
What are you looking for from your parrot?
*
Talker
Mimicker
Cuddlier
Shoulder Buddy
Vibrant Colors
Full Time Companion
Companion for Another Bird
Possible Breeder Companion
Personal Companion
Companion for Another Person
Other
Other:
Have you selected a parrot from the website?
*
Yes
No
I understand that I must select a parrot from the website to adopt to be contacted for an appointment
*
Confirm
Please select just one parrot or one bonded pair of parrots from our website.
*
Confirm.
Please list the name of the one parrot, Or 1 pair of bonded parrots * All bonded paired are placed with two cages.
*
What interests you about this parrot / parrots
*
In the event of any emergency. We will provide you with 1 month of free boarding. *All of our adopters need one LOCAL PERSON - That is within 1 hour radius of your home as your local Parrot guardian who lives close to you. Please enter your designated guardians information below
*
First
Last
Guardian's phone
*
Guardian's email
*
Guardian's Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Are you aware that parrots at times can be extremely vocal?
*
Confirm.
Do any members of your household object to you adopting a parrot?
*
Yes
No
Please list the names and ages of everyone in your household:
*
Do you have parrot experience
*
Yes
No
Some
No parrot handeling experience
If you have parrot experience, how much parrot experience do you have
*
No medium or large parrot experience
6 months to 1 year
6 months to 1 year medium or large parrot experience
1 year to 2 years of medium to large parrot experience
2 years or more of medium or large parrot experience
Other
Do any members of your household smoke or vape? Please be honest, the health of our parrots is very important to us.
*
Yes
No
Do you have other pets?
*
Yes
No
What type of animals do you currently have?
Please list the breed, name and years that your pet has lived with you.
Do any of your pets exhibit aggressive behavior?
*
Biting
Nipping
Growling
None
Please explain what causes these behaviors and how you correct them:
Would you be willing to take a 60 minute parrot educational class about this breed of parrot/parrots
*
Yes
No
not necessary
Have you had any medium or large parrots in the past?
*
Yes
No
Do you still have this parrot?
*
Yes
No
What types of parrot or parrots do you currently have, and how long have you had your parrot/parrots
*
If you no longer have this parrot, can you explain why
If you have a local avian veterinarian. If so, what is your veterinarians office name
Avian veterinarians name?
Veterinarians Phone
Veterinarians Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
You are aware there is a rehoming/adoption fee payable to the SCBR Parrot Rescue?
*
Yes
No
I/ We understand that adoption fees vary with every parrot. This is based on different factors such as: Age/ Condition / Tameness/ mimicking abilities and more...
*
Yes
No
Do you feel you are financially able to provide for a bird/parrot's needs in terms of Veterinarian costs, food, housing, toys, grooming, etc.?
*
Yes
No
Upon your approved application & Meet & Greet. What area do you plan to have your newly adopted parrot live at?
*
Your Bedroom
Your Bird Room
Your Livingroom
Your Side room attached to your home
Your Garage area /With Or without other birds
Your Den
Your Kitchen area
Outside cage area
Other area
Are you willing to keep your home at a temperature that suits the needs of your bird whether or not you're at home?
*
Yes
No
What temperature range?
*
Are you aware that there is no such thing as a quiet parrot?
*
Yes
No
Are you aware that there is no such thing as a parrot that does not bite or nip at times?
*
Yes
No
Are you aware that exotic birds are capable of destroying property?
*
Yes
No
Are you aware that exotic birds are very messy in terms of droppings and food splattering?
*
Yes
No
Do you know that exotic birds NEED and REQUIRE a lot of attention and care?
*
Yes
No
*Are you aware that behavioral modification may take years of patience and consistency to build a relationship of trust and companionship?
*
Yes
No
I/we understand that our application Will Be DENIED TO If you have misrepresented yourself on this application
*
Confirm.
Do you work from home
*
Yes
No
Traveling job
If you work away from home, how many hours a Week do you work
*
10 to 20 hours away from home
20 to 40 hours
40 hours or more away from home
I’m / We're retired
Other
If other, how many hours of work per week to you work
Do you happen to work in any of these professional fields;
*
Hazardous materials field
Medical field
*Retired Law Enforcement
Emergency Medical Services
Agriculture field
Livestock field
Animal breeder field
Veterinarian field
US Retired Veteran
Other
If other what type of work do you preform
Would you like to add anyting to your application
I/we are prepared and ready to adopt within 72 hours...
*
Yes ready to Adopt with 72 hours
No - Not ready to Adopt with 72 hours. If not, we understand that we can not apply to adopt for another 6 months from todays date
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