Surrender Form_Birds – NOCO Humane

Phone

Email

What brings you to NOCO Humane to surrender your bird?

What is your bird's name?

What breed is your bird?

How old is your bird?

How did you acquire your bird?

How long have you owned?

Who is your veterinarian?

Does your bird have a bird band?

Any known medical issues, dietary restrictions, or prescriptions?

Has your bird ever been outside?

Are your bird's wings clipped?

Is your bird on a specific diet?

Does your animal display any behaviors worth noting?

If you answered Yes to the question above, please describe the situation and how it happened:

To the above question, who or what type of people have these behaviors occurred with? (ie. Children, men, women, strangers, veterinarians, owner, one person in particular, etc.)

If yes to the question above, were there injuries from this altercation?

If applicable, did the injured animal require medical treatment? What degree of damage was done? (ie. stitches, amputation, etc.)

If applicable, how did you stop the altercation and how easily was the altercation stopped?

Is there anything else you would like to share about your bird?

Can we call you with follow up questions if needed?

Rehoming Your Bird

Rehoming Your Bird

Rehoming Your Bird