REQUEST FOR RESCUE BY SHELTER OR OTHER RESCUE
* - required
After RMCR receives (a) this request form, (b) a recent picture of the dog and (c) a vaccination report (if any), we will review this application and contact you within 36 hours. Submitting this form is not a guarantee that RMCR will accept this dog. If this is urgent, please call us 303-617-1939 and state this is an emergency
DOG'S INFORMATION
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pounds
TESTS
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VACCINATIONS - PROOF OF VACCINATIONS REQUIRED
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MEDICATIONS
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BEHAVIOR AND CHARACTERISTICS
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ORGANIZATION INFORMATION
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If you do not have a recent pic or a vaccination record immediately available, please email to intake@RockyMountainCockerRescue.org within 72 hours
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RELEASE AGREEMENT
By clicking the Submit button below, I agree I am electronically transferring all data on this form and am certifying (a) I am the guardian (also known as the "owner") of the dog described herein and can provide proof of ownership; or (b) I am the authorized representative of the guardian or owner of the dog described herein and can provide proof of such authority, such as Power of Attorney; or (c) I found this dog abandoned and have actively sought the rightful owners for at least seven (7) days and failed to locate them. I also certify I have unrestricted and complete authority to surrender this dog to Rocky Mountain Cocker Rescue, Inc. I understand after I surrender this dog to Rocky Mountain Cocker Rescue and they take physical possession, I relinquish all ownership rights and claims to that dog and that my ownership rights are terminated. I agree that by clicking on Submit, I am also electronically signing this form and a physical signature is not required to proceed with surrendering this dog to Rocky Mountain Cocker Rescue.
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