Ozaukee Humane Society - Bird Adopter Profile Form

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Available Dogs for Adoption

Available Cats for Adoption

Available Small Animals

Gift of Companionship

Bird Adopter Profile

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*First name:

*Last name:

*E-mail:

*Address line 1:
Address line 2:

*City:

*State:

*Zip:

*Home phone:
Daytime phone:

Home ownership:
Residence type:
Landlord name:
Landlord phone:

Have you ever adopted from the Ozaukee Humane Society?
Does anyone in the household have allergies to animals?
If yes, can the allergies be controlled by medication?
Is there a smoker in the household?

If yes, how will smoke be kept away from the bird in order to prevent respiratory disease?

Do all adults in your household know that you plan to adopt?

# of adults in home:
# and ages of children in home:

This bird is being adopted as: (Check all that apply)
House PetOutside PetBreeder
GiftCompanion for Other PetFood for Other Pet
Classroom Pet

Who will be the bird’s primary caretaker (feed, train, monitor health and clean cage)?

What type(s) of pet(s) have you owned during the past five years?

Type/Breed	Kept Where?	Age	Name	Still Own	Spayed/ Neutered?

If you no longer have the above pet(s), please explain what happened to them?

If you have a veterinarian, please provide his/her name and the clinic name.

If you currently have pets at home, how do you plan to introduce them to your new bird?

If you will allow your bird time out of its cage with other pets, how will they be supervised?

If you have cats, please be aware that a puncture by a claw or tooth will require veterinarian attention within one hour or less in order to counter-affect the fatal bacteria in the bird’s bloodstream.

What type/size cage will the bird have?
Where will the cage be kept?

Typical bird behavior includes chewing, screaming, singing, and making other loud noises. How will you provide opportunities for your new bird to engage in these activities without destroying your home?

Additional comments you want to share with us. ** Please note, if you have specific questions you'd like answered before your visit to OHS, please call us at 262-377-7580.

I certify that I am at least 18 years of age and the information I have given is true. I recognize that any misrepresentation of facts may result in my losing the privilege of adopting a companion animal and I understand that the Ozaukee Humane Society has the right to deny my application.

I am fully aware that I am adopting a living creature and as such that the Ozaukee Humane Society is unable to guarantee the health of the animal.

If this animal becomes ill, I certify that I am financially and/or emotionally prepared to treat this animal at my own expense.