Surrender form | Beak N Wings

NEED A PARROT SURRENDERED?

A REAL HOME Environment For YOUR Parrot!
Surrendered parrots live both in homes and the facility.

We urge you NOT to release your birds outdoors or list your pet birds(s) on various online sites. If you are contemplating those choices, please contact us at adopt.bnw@gmail.com , 913-322-3398

Surrender form
See below for our surrender form
No shame. Just safety, care, and compassion.

Making the decision to surrender your birds can be a difficult choice. We are here to assist you in making the process as smooth as possible, but we require as much information as you can provide to ensure we find them the best home.

If you have more than five (5) birds of the same species, please use the (pdf format) Send this form to adopt.BNW@gmail.com

Mulit bird surrender form

Beak n Wings Online Surrender Form

One ( 1 ) bird per form

Beak n Wings, Inc.

An Educational Pet Bird Club & Rescue

501(c)3 Non-Profit organization

EIN: 77-0630832

9010 Rosehill Rd., Ste. B., Lenexa, KS 66215 913-322-3398

adopt.BNW@gmail.com beaknwings.org

Single bird surrender form Office Use: Bird Number______________________________

One ( 1 ) bird per surrender form

Thank you for taking the time to complete the Surrender Form in its entirety. The information provided will help us understand your birds' needs. Please do not hesitate to call with questions or assistance in completing this form. If placement is the only alterative for you, contact your veterinarian for complete medical records and return to Beak n Wings.

What are you doing today?

Surrendering my bird

Returning My Bird to Beak n Wings

Date of Surrender

Month

Day

Year

Contact Information

Owners First name

Last name

Address

City

State

Zip Code

Home Number

Work/Cell

Email

Drivers License Number:

Upload Drivers License/ID Card

Release Information

I declare that I am the current and rightful owner of Bird Name (only one bird per surrender form) I agree to relinquish ownership and all rights to the below listed animal (bird). As of this date listed above the described animal belongs to Beak n Wings, Inc., to do with as necessary and humane.

Digital Signature

Bird Name

Bird Species (i.e. Cockatiel, Amazon, Macaw)

Age

Sex of Bird

Please upload a couple of good pictures of the bird you are surrendering

Veterinary Information: I hereby authorize the release of all medical records pertaining to the above listed bird to representative of Beak n Wings.

Avian Vet's Name

Address, City, State, Zip Code

Veterinarian Phone Number

Please type your digital signature below. By signing, you are giving Beak n Wings permission to to obtain all medical information from listed veterinary listed above.

Confirm

Digital Signature

Bird Information

When did you acquire your bird?

DNA Sexed? (if DNA sexed, can you provide certificate)

Yes

No

Microchipped?

Yes

No

Does your bird step up on command?

Yes

No

Has your bird ever laid an egg?

Yes

No

Not sure

Can your bird fly?

Yes

No

Not sure

Can fly but not well

If other, please explain.

Injuries/surgeries

If yes, please explain here.

Feather Condition

Health: Have you had a bird die in your home?

If yes, explain why and how here.

Have you ever had a bird tested positive for any viruses such as Bornaviruse, Beak & Feather?

If yes, explain here

Please understand Beak n Wings does not take in sick birds. If for some reason the surrendering party was not truthful with Beak n Wings on this form, phone, text, or email we could end up putting the bird down, depending on the illness. Beak n Wings does not have the funds to treat unwanted birds due to illness.

Many viruses, bacteria will transfer from bird to bird via air,, waste, eating, or drinking after each other, living in the same cage. Please be aware that if you have or had a sick bird, that does not mean every bird is sick, but Beak n Wings really needs to know if there is or was a sick bird in the home so that we do not place the bird in a foster home taking a chance of infecting even more birds. Please be honest when filling out the surrender form so that we can better protect our other birds.

If you have had a sick bird at some point, this does not mean we will not take the bird. We prefer the bird if sick less than six (6) months have a vet send a health certificate stating the bird appears to be healthy.

Does the bird say bad words?

If yes, please explain.

Explain your answers from above.

Does your bird have a favorite food? Explain below. If no type NO.

Sleeping habits, (explain below if needed)

Cage/Perches/Toys - Describe your bird's cage

Cage Surrender:

Cage is in:

Perches:

Toys:

Explain Bathing if needed.

Routine Care:

Who is your bird's primary caregiver?

Describe your bird's playtime activities

Does your bird have night frights? If yes, explain below below

Explain night frights if needed.

How many hours a day does your bird spend home alone? Explain if needed

Do you leave the radio, TV, other audio/video on for the bird?

Explain here if needed

Please tell us more about the bird that we might not have listed

List any changes within your household that may have contributed to the above behavioral problems

Why are you considering placement of your bird with Beak n Wings?

Would assistance with education or behavior modification be possible as a means for you to keep your bird?

If yes or no, please explain

By signing below I have filled in the form honestly and to the best of my knowledge

Confirm

Date signed

Month

Day

Year

Digital signature

Beak n Wings Representative Signature & Date

Beak n Wings Representative Printed Name

See below for more information

2003 = 58

2004 = 124

2005 = 110

2006 = 200

2007 = 177

2008 = 164

2009 = 210

2010 = 64

2011 = 142

2012 = 100

2013 = 106

2014 = 110

2015 = 49

2016 = 74

2017 = 160

2018 = 126

2019 = 126

2020 = 138

2021 = 121

2022 = 107

2023 = 117

2024 = 117

2025 =

Total to date 2,735

Updated 8/11/2025