Bird Surrender Form

Please fill out the below form if you need to surrender a parrot to STAR. Please note, as a foster-based rescue, wait times can vary.
A member of our intake team will reach out within 72 hours of receiving your surrender form with any additional questions, next steps, and will be able to answer any questions you have.
If you do not receive an email from us, please check your SPAM folder. If you have not heard from us, please email intake@staravian.org.

Date:
Contact Information
First Name
Last Name *
Address *
State *
City *
Zip Code *
Phone Number *
Email *
Surrendered Bird Information Please be as truthful about any issues as possible. Behavior and/or medical issues will have no bearing on bringing a bird into our foster program. More information will allow our team to ensure that proper placement is made within our foster homes and will allow our team to be able to offer any potential advice to managing any issues until we are able to bring them into our program.
Bird's Name *
Species *
Subspecies or coloring *
Age (Hatch Date if known)
Sex	Female Male Unknown
If known, how and when was the sex verified?
When did you acquire the bird?
Where did you acquire the bird?
If other, please explain
What is the bird's history?( Previous owner, reason previous owners couldn't keep) *
Bird's favorite phrases/ games
Current Diet
Describe your bird's current diet. Please be as specific as possible, Include brand name. *
Does your bird have favorite treats or foods?
Are there any foods that your bird dislikes or has a negative reaction to?
Do you have vitamin supplements?
Veterinarian Information
Do you currently have an avian veterinarian?
Clinic's Name
Avian Vet Name
Address
City, State, Zip Code
Phone Number:
How often did you take the bird to the vet?
When was your bird's last vet visit?
What was the reason for this visit?
Is the bird banded?
If yes, what is the number?
Is your bird micro-chipped?
If yes, what is the brand?
Describe your bird's overall physical condition. *
Has your bird ever sustained any injuries?
If yes, please describe:
Has your bird ever had surgery?
If yes, please describe and give reason:
Has your bird ever been treated for any diseases?
If yes, please describe:
Has your bird ever taken any medications?
If yes, please list and give reason:
Has your bird ever been on herbal or other alternative therapies?
If yes, please describe:
Routine Care
Who is your bird's primary caregiver?
Are you donating the cage with the bird?
If yes, please describe the cage:
What type of perches does your bird prefer?
Describe some of your bird's favorite toys.
Please 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?
Do you cover your bird’s cage at night?
Describe your bird’s bathing habits, including frequency, likes, and dislikes:
Describe your bird’s play area(s):
How much time does your bird spend outside the cage each day?
How do you provide daily exercise and entertainment for your bird?
How much time does your bird spend alone?
Do you leave the radio, TV, or other audio/video on for your bird?
Behavioral Information
Is your bird destructive?
If yes, please describe:
Is your bird hand tame?
Does your bird interact well with other birds?
If no, please describe:
Has your bird been around other animals? If yes, please describe (i.e. frightened of dogs, ok with other animals ...etc). *
Who is your bird’s favorite person?
Does your bird interact well with other household members?
If no, please explain:
Does your bird like children?
How does your bird react to strangers?
Does your bird have any known behavioral problems (i.e., screaming, plucking, aggression, etc.)?
If yes, please describe (Please be as honest as possible. It will not affect our acceptance of your bird, but it will help us in understanding his/her behavior, and will enable us to provide the best placement situation):
Why do you feel surrender of your bird is your only option? *
Would assistance with education or behavior modification be a possibility as a means for you to keep your bird?
How did you learn about St. Louis Avian Rescue? *
Additional comments or information you think we should know?
Optional: Provide a photo of your bird(s)
Optional additional photo
Do you have veterinary, adoption, hatch or other records (i.e. DNA certificates) that you would be willing to share with us? If yes, please upload a copy below or email copies (at your convenience) to records@staravian.org (along with the name and species of the bird). If you are not able to upload or email, a paper copy may be given to a STAR representative at the time of intake.
Optional: Copy of Medical or other records
Optional: Copy of Medical or other records
Optional: Copy of Medical or other records
If you are donating a cage or other supplies, please include photos below. Please note, donation of cages/supplies does not affect the decision to bring birds into our program.
Optional: Photo of Cage and/or Supplies
Optional: Photo of Cage and/or Supplies
Optional: Photo of Cage and/or Supplies
Would you be interested in making a monetary donation to STAR to assist in covering veterinary and other costs incurred by your bird while in foster care. *
While we do not require a fee for placement into our program, as a nonprofit that runs off of donations, it is always appreciated.
VETERINARY INFORMATION RELEASE:
I hereby authorize the release of ALL veterinary medical records to representatives of St. Louis Avian Rescue for the following bird(s). Bird Name *
I, hereby donate to STAR - St. Louis Avian Rescue, the above listed bird to be placed in this organization’s adoption program. I relinquish all claims to the above listed bird. This form is complete and true to the best of my knowledge. *
A copy of this document may be provided to the adopting party. If you wish us to withhold your name and contact information. *
Are you surrendering this form on behalf of another person? *
Please provide the full name of who you are submitting this form for. *
All information listed above is true and accurate to the best of my knowledge. *
Signature Instructions: Use your mouse to sign your name by clicking and holding it down as you write if not using a touchscreen device.
Signature

Once submitted, our intake team will reach out in the next few days to confirm confirmation of your application, ask any follow up questions and to go over next steps.
If you do not receive an email from us, please check your SPAM folder.
If this is an emergency, please email intake@staravian.org after submitting this form.

Bird Surrender Form

Contact Information

Surrendered Bird Information

Current Diet

Veterinarian Information

Routine Care

Behavioral Information

VETERINARY INFORMATION RELEASE: