Temporary Bird Care Agreement

Temporary Bird Care Agreement
Temporary care commencement date

DayMonthYear
Date
Expected temporary care end date*

DayMonthYear
Date
*can be extended by mutual agreement
Owner Details
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number(s)
Please list a minimum of one, preferably two phone numbers
Next of Kin/Trusted Person

This could be someone who has Power of Attorney, your legal representative, or simply someone nearby who you know and trust to make decisions regarding your bird’s care if for any reason you are unable. Please ensure that your trusted person is aware of the temporary bird care arrangements - you should provide them with a copy of this document.
Name

First NameLast Name
Relationship to you
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number(s)
Please list a minimum of one, preferably two phone numbers
Bird Details

Please provide as much detail as possible.
Bird Name
Species
Age/approx. hatch date
Any known health issues e.g. illnesses, deformities
Does the bird(s) have any allergies?
If yes, please provide details below
Has the bird(s) been disease tested?
If yes, please provide details below
Is the bird(s) registered with a vet? If so, please provide the vet/surgery's name and contact information, and detail any previous treatment received.
*Please note that if your regular vet is not The Lawrie Veterinary Group and we cannot reach your regular vet for any reason, we will default to Lawrie Vets for emergency care. As the bird’s owner, you are responsible for any veterinary costs incurred during the temporary care period.
Please detail the daily routine for your bird(s), including full diet
Contingency
Details of the person who is to take over the permanent care of your bird(s) if for any reason you are unable to do so.
Is this to be your Next of Kin/Trusted Person as detailed above?
If no, please provide further details below
Name

First NameLast Name
Relationship to you
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number(s)
Please list a minimum of one, preferably two phone numbers
Email
example@example.com
Are they aware of this agreement?
Disclaimer
By signing below, I hereby certify that I am the rightful owner/custodian of the above listed bird(s) and will remain so during the temporary care period.
I confirm that I have made my next of kin/legal representative aware of these arrangements.
I understand and agree that although Parrot Trust Scotland and their representatives will take every step to act in the best interests and care of the above listed bird(s), including transporting the bird(s) to an avian vet if this is deemed necessary, Parrot Trust Scotland and their representatives are not responsible or liable for any unexpected illness or injury which may occur during the temporary care period.
I authorise the treatment of the above listed bird(s) by an avian veterinarian, and I accept full responsibility for all fees and charges incurred in this treatment. Parrot Trust Scotland is authorised to transport the bird(s) to an avian vet, and if I cannot be reached, to act on my behalf to authorise any necessary treatment.
I assume full responsibility for the payment of all veterinary services rendered and will pay these costs directly to the veterinary surgery upon invoice.
In the event of the bird’s death, I consent to a veterinary post mortem examination.
YesNo
In the event that I am unable to resume permanent care of the above listed bird(s) and the above listed contingency contact is unable or unwilling to do so, I authorise Parrot Trust Scotland to find a suitable, permanent home for the bird(s) through the charity’s rehoming programme.
I understand and agree that I am responsible for all costs relating to the care of the above listed bird(s), including all daily food and care costs and any emergency veterinary fees which may arise, and I will ensure that these costs are paid either directly to the veterinary surgery or to Parrot Trust Scotland where appropriate.
I confirm that I have checked the contact details which I have provided, and that all information provided on this form is correct to the best of my knowledge.
Signature
Date of signature

DayMonthYear
Date
The board of directors will now review this agreement. Upon board approval a countersigned copy will be emailed to you at the email address you have provided.
Should be Empty:

Temporary Bird Care Agreement

Owner Details

Next of Kin/Trusted Person

Bird Details

Contingency

Disclaimer