Owner Relinquishment Request

Thank you for your interest in relinquishing a bird to Exotic Bird Rescue of Oregon. At EBR, we believe that exotic birds make great companions, but also recognize that it is not always feasible to keep them. Before making the decision to surrender, please consider all of your options.

If you are wanting to relinquish your bird due to behavioral issues, we may be able to help keep your bird in your home by offering you coaching or a referral to a behaviorist. If you are still certain you want to relinquish, submit the form below. This form will help us understand your situation, the urgency level, and how to best care for your bird. Keep in mind that EBR is currently operating at full capcity. Filling out this form does not guarantee immediate intake and it may take some time before a foster home opens up.

Exotic Bird Rescue is a 501(c)3 non-profit corporation dedicated to the rescue, rehabilitation and health of exotic birds through education, research and service.

You have asked Exotic Bird Rescue to take ownership and care of your bird. We have found that the transition into the rescue for a new arrival is much easier when the bird is surrounded with its familiar belongings. If possible, please provide us your bird’s cage, dishes and toys. The rescue is asked to accept hundreds of birds annually into the rescue. It is financially impossible for us to do the right thing by our birds without your financial support to help cover costs for medical care, housing, toys, food and day-to-day operations of the rescue.

Your responsibility does not end when your bird is placed with us. We ask that you consider a contribution to offset the care of your bird until the time that we are able to place it in an approved adoptive home. Should your bird come to Exotic Bird Rescue for permanent placement, we request that you consider a monthly or annual donation on behalf of the welfare of the bird. Many of the parrots that come to the rescue are from true rescue situations and have not been as fortunate as your bird. Your financial contribution enables us to offset some of the costs incurred with rescue so that we can continue with those efforts.

By signing this Owner Release Agreement (the “Agreement”), you transfer ownership of the bird described above (the “Bird”) to Exotic Bird Rescue of Oregon. In addition, you agree to all the terms of this Agreement.

• If for any reason, the Bird is returned to you, you agree to reimburse Exotic Bird Rescue for all expenses of caring for the Bird, such as veterinary care, food, toys, boarding, and overhead expenses.
• You warrant Exotic Bird Rescue that you are the sole owner of the Bird, have the right to transfer its ownership to Exotic Bird Rescue, and that there are no encumbrances on or other ownership interests to the Bird.
• You agree to defend, indemnify and hold harmless Exotic Bird Rescue, its agents, directors, officers, employees, volunteers, and affiliates from and against any and all actions, claims, damages, losses and expenses (including reasonable attorneys’ fees) if any of the above warranties are incorrect or incomplete, or if you breach this Agreement.
• You agree without additional consideration, to sign, acknowledge, deliver any other documents and take any other action necessary or appropriate and reasonably requested by Exotic Bird Rescue to carry out the intent and purposes of this Agreement.

Oregon law will govern this Agreement, and you agree that any litigation arising under this Agreement will be brought into a court having jurisdiction within Oregon. In any dispute, the prevailing party shall recover reasonable attorneys’ fees and costs. Release of your bird to Exotic Bird Rescue starts the adoption process. We will do everything possible to ensure that this bird is placed into a home that will satisfy its individual needs and match those of its new owner.

First Name *
Last Name *
Email *
Phone Number *
Street Address *
City *
State *
Zip Code *
Bird's Name *
Species *	African Grey Amazon Caique Canary Cockatiel Cockatoo Conure Finch Lori Lovebird Macaw Parakeet Parakeets Parrot Pionus Unknown
Subspecies
Color *	Black Blue Brown Green Grey Orange Purple Red Unknown Various White White and Black Yellow Yellow and Grey
Estimated Age * Please enter a number larger than 0
Hatch Date
Sex	Unknown Male Female
Sex determined by:	Unknown Blood Coloration Feather Surgical Egg Assumption
Is this bird banded? *	NoYes
Band description and number:
Microchip information and number:
If possible, please provide a photo of the band:
Photos are required and help engage adopters and potential foster homes. Please upload a photo of your bird here:
If you have an additional photo of your bird you may upload it here, or send it via email to intake@ebroregon.org:
Where did you get this bird?
How long have you had the bird?
Previous owners' contact information (if known)
Cage size:
Cage type:	Unknown Powder Coated Stainless Steel Galvanized Other
If possible, please provide a photo of the cage.
Types of perches in cage:	Unknown Natural wood Shelf Other Sand or Cement Plastic None Rope Dowel
Number of perches:
Type of toys:	Leather Sisal Paper Cotton Plastic Other Rope Wood None
Number of toys:
Favorite Toys:
Cage is lined with:	Newspaper Cage litter Nothing Other
How often is cage cleaned?
How is the cage cleaned?
At night the cage is covered with: *	Nothing Bird Cage Cover Blanket Sheet Other
What room is the cage located in?
What is the activity level of the home?	Unknown High Medium Low
Is cage placed near any of the following? *	Humidifier Heater Air vent Air Filter Wood stove Window Oil Stove Air conditioner Pellet stove None of the above
Does the bird have any of the following?	Cage cover Playstand Travel cage Sleep cage Harness Other None of the above
How many hours a day is the bird usually out of its cage?
How often is the bird alone?
When does the bird wake up/lights on?
When does the bird go to bed/lights out?
Is there anything else we should know about the birds housing or routine?
Please describe your birds dietary routine. Include what and when you feed the bird. Include vegetables, fruits, nuts, pellets/seeds (including brand) and treats. *
What is their favorite food? *
What type of water do you use for the bird? *	Purified Tap Well Water Bottled Other
How does your bird bathe? How often? *
Is this bird able to fly? *	Unknown Chooses not to Flies frequently Per vet, physically unable to fly Wings are kept trimmed
Is this bird used to being toweled? *	Unknown Yes No
Is this bird step-up trained? *	Unknown Yes, to a dowel Yes, to hand or arm
Is this bird target or clicker trained?	Unknown Yes Somewhat No
Is this bird harness trained?	Unknown Yes Somewhat No
Bird's vocabulary and tricks, if any:
Has this bird been allowed on shoulders?	Unknown Yes Sometimes No
Does this bird get along with men? *	Unknown, or has not been around Comfortable Tolerates Prefers Aggressive Fearful
Does this bird get along with women? *	Unknown, or has not been around Comfortable Tolerates Prefers Aggressive Fearful
Does this bird get along with children? *	Unknown, or has not been around Comfortable Tolerates Aggressive Fearful
Does this bird get along with dogs? *	Unknown, or has not been around Comfortable Tolerates Aggressive Fearful
Does this bird get along with cats? *	Unknown, or has not been around Comfortable Tolerates Prefers Aggressive Fearful
Does this bird get along with other small animals? * Unknown, or has not been around | Comfortable | Tolerates | Aggressive | Fearful	Unknown, or has not been around Comfortable Tolerates Prefers Aggressive Fearful
What are the bird's best qualities? *
What are this bird's biggest challenges? *
Does this bird have any phobias we should be aware of?
Has this bird seen a vet? *	NoYes
Name of Veterinary Practice:
When was this bird's last vet visit? *
What was your bird last seen at the vet for?
Does this bird have any known health issues (including feather destruction)? If so, please describe. *
This bird has had the following diagnostic tests: *	Physical Gram Stain Radiographs Blood Test Culture Other None
This bird has been exposed to: *	Other exotic birds Bleach Aerosols Chickens, or other poultry Candles Teflon Lead Air freshners Nail polish Zinc Household cleaners Nail polish remover Smoke or vape Perfumes Harsh chemicals/fumes None of the above
Was this bird ever used for breeding? *	NoYes
Does this bird have any offspring? If so, how many? *
When was the last time this bird laid an egg?
Please tell us your reason for relinquishing this bird. *
When is your requested deadline for intake? *
Please provide a biography for your bird, including likes and dislikes, daily routine, any cute behaviors, and funny things it says or does. This helps quicken the adoption process. *
*	I have read the agreement at the top of this form, understand it, and agree to its terms.
*	I understand a PayPal invoice will be sent to me upon my bird going into a foster home. If I have any questions regarding the fee or invoice, I will contact the Intake Coordinator at intake@ebroregon.org.
*	I understand foster homes are often full and that EBR cannot guarantee intake of my bird. I understand that EBR may place my bird on the waitlist. If my bird is waitlisted it will be posted on the EBR website and/or social media pages as being on the waitlist. If an approved adopter wants to meet my bird before a foster home is available, an EBR volunteer will reach out to me with my available options, as well as instructions if I choose to allow someone to visit.
Signature *	Clear
Date *