Majestic Waterfowl Sanctuary, 17 Barker Road, Lebanon, CT, 06249

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Adoption FAQ

Online Owner Surrender Form

  Website Forms Under Construction!  

Our webhosting company no longer supports our Frontpage software.
In response, we are transitioning our online forms over to Dreamweaver software.
In the meantime, the below Owner Surrender Form is non-functional.
Please email us using this page as a guideline as to what we need to know about your duck or goose.
director@majesticwaterfowl.org
We apologize for any inconvenience this may have caused and are working diligently on the issue.

Please complete the form below. After receiving the information we will contact you to discuss whether we can accept your duck or goose into our rescue shelter. All owner surrenders must be hand delivered to the Majestic Waterfowl Sanctuary or shipped at the owner’s expense.

Please complete a separate form for each duck or goose. Due to space limitations, we have never taken more than two birds from any one home. Sorry, but we cannot accommodate large flocks.

ATTENTION: If the bird(s) you wish to surrender are not located in the state of Connecticut, please click here before filling out the form below.


Owner Surrender Form

Information about the Owner
 
Owner's Name:
Address:
Address:
City: State: Zip:                        
E-mail: *If you enter an incorrect email address, we cannot respond to your inquiry. Double check it!
Telephone:
Time Zone: ET PT CT MT
Confirm Age: I am 18 years of age or over   
*If you are under 18, please have a parent or legal guardian complete this form for you.


Information about the Duck or Goose
 

Name:
Species: Duck    Goose
Breed:
Feather Color
Gender: Male    Female   Unsure? Please Click Here to find out!
Age: years and months
Date of Hatch:   (If known)

How did you acquire this duck/goose?

How long have you owned this duck/goose? years and months

Primary caretaker of this duck/goose: Male    Female

Age of Primary Caretaker:

Under 12   13-20   21-30   31-40   41-60   60+

Duck/goose kept primarily: Indoors    Outdoors

Can this duck/goose fly? Yes    No    Wings Clipped? Yes    No

Please describe the daily diet of this duck/goose:

If this duck/goose is FEMALE, is she currently laying eggs? Yes    No

Have all eggs been normal with a smooth, hard surface? Yes    No

If not, please describe any problems/irregularities:

What kinds of birds were kept with this duck or goose?
 
  Number of Males
(List number)
Number of Females
(List number)
None    
Ducks
Geese
Chickens/Roosters
Turkeys

Why do you want to surrender this duck/goose?


Medical Information

Has this duck/goose ever been seen by a veterinarian? Yes    No

If yes, please complete the following:

Vet's Name:
Address:
Address:
City: State: Zip:
E-mail:
Telephone:

Date of last vet visit:

Please list any medical problems or physical disabilities:

Has this duck/goose ever experienced sudden drastic loss or gain of weight?
Yes    No

If yes, please describe:

Has this duck/goose been wormed within the past three months? Yes    No

If yes, when:

Brand/Type of Wormer Used:

Has this duck/goose ever had a disease or illness? Yes    No

If yes, please provide dates and details:

Date: Illness/Disease Vet Seen? Recovered?

Yes    No Yes    No
Yes    No Yes    No
Yes    No Yes    No

Has this duck/goose ever taken medication? Yes    No

If yes, please provide dates and details:

Date: Medication Vet Prescribed? Still Taking
this Medication?
Yes    No Yes    No
Yes    No Yes    No
Yes    No Yes    No

Has this duck/goose undergone any herbal/alternative medicine or therapy?
Yes    No

If yes, please describe:

Does this duck/goose have any current health problem, injury, or illness that
requires medication and/or specialized care?
Yes    No

If yes, please describe:

Please describe below any past health problems, injuries, or illnesses:

Photograph

If you have the capability of sending a digital photo of your pet:

After submitting this Owner Surrender Application to us, immediately email us a clear, sharp and bright photo of the duck or goose you are interested in surrendering. Please do not send us links to view photo albums. Applications that include digital photos are placed higher on the waiting list than those that come without.

In the body of the email please include your full name and the name of the ducks/geese in the photo.

If you do not have the capability of sending a digital photo of your pet:

After submitting this Owner Surrender Application to us, we will email you if we have room at our sanctuary to assist you. If we request a photo of your pet, please write your full name and address on the back of the photo and the name of the duck or goose. Be sure your photo is clear, sharp and bright. Our open slots fill quickly, so please mail your photo immediately upon request to:

Majestic Waterfowl Sanctuary
17 Barker Road
Lebanon, CT 06249

Please include a SASE if you would like your mailed photo returned to you.

Which type of photo will you be sending us? 

Immediately Emailing A Digital Photo  Snail-Mailing A Photo Upon Request

 


Behavioral Information

Does this duck/goose sometimes bite people or other animals? Yes    No

Is this duck/goose imprinted on humans? Yes    No

Please check the personality characteristics that best describe this duck/goose:

Lap Bird: This duck or goose will walk up to greet their caretaker and loves to be petted and picked up.
Welcoming: This duck or goose will walk up to greet their caretaker to be petted, but prefers not to be picked up.
Friendly: This duck or goose will not approach their caretaker, but their caretaker can approach the animal and freely pet them. The animal prefers not to be picked up.
Shy: This duck or goose will not approach their caretaker, but their caretaker can come within three feet of the animal. The animal will sometimes allow limited petting.
Timid: This duck or goose will run approximately between five and ten feet away from their caretaker before stopping. They will rejoin the flock once the caretaker has backed away.
Nervous: This duck or goose will run from their caretaker and keep on running. The animal is fearful of humans to the point of risk of self-injury or escape.
Aggressive: This duck or goose will chase and attempt to bite their caretaker.

Please list anything else you think we should know about this duck/goose:

Please describe the daily routine of this duck/goose:

Acknowlegement

By submitting this form, I certify that the information provided within is true and accurate.

I understand that Majestic Waterfowl Sanctuary retains the right to decline the acceptance of my bird into their sanctuary at any time prior to the mutual-party signing of Majestic’s Owner Surrender Contract. I understand and agree that I am not entitled to any explanation or compensation (monetary or otherwise) of any kind whatsoever should Majestic choose not to accept my bird into their sanctuary.

I also understand that in most cases a minimum donation of $100 per bird is required to help defray Majestic's expenses.

Release of Veterinarian Records

 

Majestic Waterfowl Sanctuary 2005, 2006, 2007, 2008, 2009

 
 

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