Copyright 2001 CPCRN

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Contact Info

[Animal Neglect]

[Report a Cairn in Need of Rescue]

[Owner Surrender Form]


Aug 15, 2011 - ATTENTION - We had difficulties receiving form emails from approximately July 27 to August 10. Our ISP has since fixed the problem, but if you filled out ANY CPCRN form between those dates, we probably did not receive it. If we did not contacted you about your email, yours was among the missing. If you would do a REPLY ALL of a copy of your auto response email, we will contact you. We are very sorry for the inconvenience. We were told it was fixed on Aug 10. If you filled out a form or sent an email to us in that time period, please resend it - or send your copy of our form to us. Thank you again for your patience.


Animal Neglect

What is animal neglect or abuse? Most people have probably seen an animal at some time in their lives that they truly felt was being mistreated or neglected. Knowing that an animal is being neglected or abused is difficult to see and it could also be difficult to talk to those who own the animals about the neglect. With the link below, you can now report animal neglect anonymously. Animal neglect may be subtle or blatant. One common example of animal neglect could be a neighbor who leaves their dog outdoors in weather that is unseasonably cold or hot without proper shelter or protection from the heat or cold or without proper food or water. Animal neglect MUST be reported to your local humane society or shelter. Their telephone number can be obtained from any veterinarian or through directory assistance or in the yellow pages of your telephone book.

In most states, counties and cities across the United States, companion animal abuse and neglect is a criminal offense. Although most crimes are Class A misdemeanors - the equivalent of a 'slap on the hand' - these crimes are punishable if reported and prosecuted. Keep this in mind the next time you see a dog that in your heart you feel is being mistreated in any way.

Report Animal Neglect

Many people feel threatened by strangers. Sometimes trying to convince a close friend or fellow co-worker to change how they treat their pets is difficult and feels awkward or intrusive. Remaining silent only prolongs the animal's suffering. PLEASE speak out. You can help save a life.

Animal Legal Defense Fund: www.aldf.org

Take action for animal justice. Sign the Animal Bill of Rights: www.animaljustice.org

Help for Chained Dogs: www.dogsdeservebetter.com

CPCRN Animal Neglect © Copyright 4/1/2001. Please contact ggreyfriar@aol.com for permission to copy or reprint.

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 Copyright 2000 Ann Priddy

Report a Cairn in Need

Please complete this form to report a Cairn Terrier or a Cairn Terrier Mix that may need to be rehomed for any reason anywhere in the United States. We work with volunteers throughout the country and through many Cairn Terrier Clubs and we may be able to help.

Please be sure to provide us with as much detail and information as you possibly can about the Cairn in need. This would include the location, the name and telephone number of the person to contact. ALL information provided will remain confidential. Thank you.

If you can read this, don't touch the following text fields.


REPORT FORM

After completion and submission of this form, you should receive a copy via e-mail shortly. Please be sure to enter a valid e-mail address before submitting the form.

If you are reporting a rescue dog that is currently being fostered in your rescue group or organization, please send photographs to ggreyfriar@aol.com. These photographs will be placed on our website. Please identify the subject line as to the content, since e-mail received without a subject line will not be downloaded. If you are unable to send photographs via e-mail, please mail these to:

CPCRN
PO Box 1354
Menifee, CA 92585-1354

If you wish to have your photographs returned, please include a self-addressed envelope.

Col. Potter Cairn Rescue Network reserves the right to edit your submission and to crop photographs.

* Required Field

* Your Name:


* Your E-mail:
Your Phone:
Alternate Phone:

Where is the Cairn located? (Please supply address if it's a private home)
URL (web site address) if this Cairn is located on the Internet:
Animal Shelter/Humane Society:
Foster Home
Boarding facility, veterinarians office, groomer:
Rescue Individual/Group/Organization:
In my care/custody
Another private residence
Other (explain):

Please provide the following for where the Cairn or Cairn-Mix is located:
Address:


City
State/Prov
Zip Code

Phone
E-mail (if known)
@

Please provide any additional information which may be helpful to us:


Please make sure the application is complete before pressing the "Submit" button below. Incomplete applications may be rejected or delayed.






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 Copyright 2001 Alyce Peters

Owner Surrender
Also known as an "owner turn-in"

Occasionally it becomes necessary for an owner or one who has power of attorney over a Cairn Terrier through the death or incapacity of a loved one or friend, to find a new home for a Cairn that can no longer be kept in a home with the owner or caretaker. For this reason Col. Potter Cairn Rescue Network has provided an "Owner Surrender" form on this site.

We realize that occasionally, those who have a Cairn Terrier are not able to keep their dog. The decision to surrender a dog to rescue should not be taken lightly. We welcome any correspondence or questions that you may have regarding this move. If you currently have a Cairn with behavioral problems, we invite you to visit the links area on this site. There are many great articles and books that deal with dogs with behavior problem. The same applies with training and health issues. Often, through a renewed training effort, many owners are able to keep their Cairn. The following link may help you with this hard decision: www.wonderpuppy.net.

If you find it necessary to surrender your Cairn to rescue, PLEASE take as much time as needed to reach this decision. Once you have surrendered your dog to rescue, your release is legally binding. The final decision to accept your dog into the CPCRN rescue program rests solely with CPCRN.

It is important to know that if you do try to place your Cairn yourself, PLEASE spay or neuter your pet PRIOR to offering your Cairn for adoption if your Cairn has not already been altered. There are many unscrupulous back yard or puppy mill breeders who watch newspaper advertisements on a daily basis and present themselves as an owner looking for the perfect pet. These puppy mill brokers can even show up at your home with what appears to be their spouse and children. Registration is not important to mill breeders. They look ONLY for the ability to breed a pure bred dog, and they will supply their own registration. Dogs are also obtained for medical research. This information is not to frighten you: it is only to make you aware of the importance of screening your potential new owners. Col. Potter Cairn Rescue Network is also more than happy to work with you to help with your placement.

Free to Good Home?
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Release of Ownership Agreement
After completion and submission of this agreement, you should receive a copy via e-mail shortly. Please be sure to enter a valid e-mail address before submitting the agreement.

PART I
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Instructions: Part I of this Release of Ownership Agreement (this "Agreement") is designed to provide Col. Potter Cairn Rescue Network with adequate information on the Cairn Terrier or Cairn Terrier mix (now referred to as the "Cairn") that you are releasing to Cairn Rescue.

General Information
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AKC Registered Name of the Cairn:


Pet name and nick names:


Is the dog a purebred Cairn or a Cairn-Mix? Pure Mix
If this is a mix, what is the mix?

Male or Female? Male Female

Age of Cairn:
Date of Birth (if known):

Please supply us with any prior known history of this Cairn if you have not had the dog since it was a young dog:



Where did you obtain this Cairn?
Pet store Breeder Adopted from shelter

Rescue organization Found as stray Other

If purchased from a breeder or adopted through a rescue organization, please provide the following information:
Name of Breeder
or Rescue Org:
Address:

City
State/Prov
Zip Code

Phone


Breeder Information
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If you obtained this Cairn from a breeder, please answer the following questions:
Was the breeder affiliated with the Cairn Terrier Club of America (CTCA)? Yes No Not sure
Was a contract signed with the breeder at the time of purchase? Yes No
If a contract was signed, will you be able to provide a copy to Cairn Rescue? Yes No
If the breeder was a CTCA member, has he/she been notified of the Cairn's release? Yes No
Do you have AKC Registration papers for this Cairn? Yes No
If yes, will you provide to Cairn Rescue signed AKC Registration papers transferring ownership? Yes No

Identification
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Color of Cairn:
Does the Cairn have black ears? Yes No
Does the Cairn have a dark muzzle? Yes No
How much does the Cairn weigh?
Is the Cairn overweight or underweight? Overweight Underweight Just right

Is the Cairn tattooed? Yes No
If the Cairn is tattooed, please provide the following information, and have any documents available:
Location of Tattoo:
Tattoo Number:
Registry:
Registry Phone Number:

Is the Cairn microchipped? Yes No
If the Cairn is microchipped, please provide the following information, and have any documents available:
Registry:
Registry Phone Number:

Does the Cairn have any scars or distinguishing features? Yes No
If so, please describe:

Diet and Treats
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Please list in detail the brand and type of food you feed (both dry and moist).
Include the measured amount fed, feeding time(s), and any special instructions for preparation (such as, mixed with broth/water):


Is the Cairn on a special health diet? Yes No
If yes, for what reason?

Are any special supplements or vitamins given? Yes No
If yes, please list these:

List any treats or special snacks by brand, type and frequency:

Medical and Health
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The information you provide in this section will be used by Cairn Rescue to (i) determine the feasibility of placing the Cairn in an adoptive home and (ii) make an informed decision with respect to the allocation of rescue resources then available.

Your submission of this Agreement (i) authorizes Cairn Rescue to contact the veterinarian listed below and obtain copies of any and all veterinary records for the Cairn if Rescue considers it necessary or advisable, and (ii) irrevocably authorizes the veterinarian listed below to provide such records to Cairn Rescue and candidly discuss the health of the Cairn with Cairn Rescue.


Veterinarian Information
Name of Practice:
Name of Doctor:
Address:

City
State/Prov
Zip Code

Phone

Inoculations and Annual Health Care
Please provide the following inoculation information:
Rabies:
Yes No
Date last given:
DHLPP:
Yes No
Date last given:
Bordetella:
Yes No
Date last given:
Lyme:
Yes No
Date last given:

Has the Cairn been tested for heartworm? Yes No
If yes, please provide the following:
Test results:
Positive
Negative
Test Date:

When was your Cairn last tested for internal parasites (worms)?


Is the Cairn on any heartworm preventative (such as HeartGard or Interceptor)? Yes No
If yes, please provide the following:
Brand:
Date last given:

Spay/Neuter
Is the Cairn spayed or neutered? Yes No
If yes, please provide the date of spay/neuter (if known):
In the event of a female Cairn, do you have any documentation to prove that she was spayed; such as a discounted rabies certificate? Yes No
If your Cairn has not been spayed/neutered and is less than 9 years old, would you be willing to have spay/neuter done prior to surrender or financially aid Rescue in having this done? Yes No

Teeth
Please provide date of the Cairn's most recent teeth cleaning by a veterinarian:
If the Cairn's teeth are in need of cleaning, would you be willing to have the teeth cleaned prior to surrender
or financially aid Rescue in having this done?
Yes No

Eyes
Is the Cairn blind, partially blind or does it have any eye problems? Yes No
If yes, please provide details:

Has the Cairn ever sustained ANY major injuries? Yes No
If yes, please provide details:

Has the Cairn ever suffered any serious diseases including, without limitation:
Diabetes, Cushings or Addison's disease, thyroid, epilepsy or seizures, hip dysplasia, skin allergies, incontinence, luxating patellas, heart or breathing difficulties, liver, bladder or digestive problems?

Yes No
If yes, please provide details:

Does the Cairn currently have any other condition that requires medical treatment or special care?

Yes No
If yes, please provide details:

Are you able to provide a complete medical record on this Cairn? Yes No

Temperament/Training
Is the Cairn housebroken? Yes No
Is the Cairn good with children? Yes No
Is the Cairn good with other dogs? Yes No
How is the Cairn with cats? Good with cats Will chase if they run NOT good with cats Not sure
Is the Cairn good with any other pets? Yes No
If yes, what other pets:
Is the Cairn comfortable riding in vehicles? Yes No
Has the Cairn had basic obedience training? Yes No

Is the Cairn crate-trained? Yes No
Do you have a crate? Yes No
If YES, what size:
Will you be sending the dog in this crate? Yes No

If you do NOT have a crate, will you supply one of appropriate size if necessary? Yes No

Does the Cairn know any verbal or hand commands? Yes No
If yes, please provide details:

Please list at least three favorable characteristics a new owner may want to know about the Cairn:


Please list any NEGATIVE characteristics a new owner needs to know about the Cairn:


What are three traits you would change about the Cairn if you could?


Has the Cairn ever bitten any human being? Yes No
If yes, please provide details:

Please tell us about special toys, games, ways they enjoy being petted, belly or ear rubs, brushing or grooming preferences:

Where does the Cairn sleep at night?

Please explain in detail why you are giving the Cairn up for possible adoption:

Did you consult with a trainer about this Cairn? Yes No
If yes, please provide the Name & Phone Number of the trainer:

Name

Phone

Personal Information
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* Required Field
* Owner Name(s):
* Spouse Name:
* Address:


* City
* State/Prov
* Zip Code

Home Phone
Work Phone

* Main E-mail
Alternate E-mail
@

Home FAX
Work FAX

Driver's Licence#

Other ID#

(ID needed
upon surrender)
To help us in our efforts to rehabilitate and rehome Cairn terriers, would you be willing to make a tax-deductible donation to our organization if we take your Cairn into our program? Yes No
If yes, how much would you be willing to donate? $


PART II
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Terms of Release and Surrender

This is a legally binding document for the irrevocable surrender of your Cairn to Cairn Rescue. Please read it carefully and completely before submitting it. Take as much time as you need to fully consider this important decision. If you have any questions, please contact us.

Your signature will be required prior to surrendering your Cairn. You must also provide proof of being of legal age in your state to sign contracts. Photographic identification with your current address will be required prior to surrender.

For good and valuable consideration, the receipt and sufficiency of which I hereby confirm and acknowledge, I, being over the age of 18 years and of sound mind, hereby irrevocably and unconditionally surrender to Cairn Rescue for placement and adoption, the Cairn described in Part I of this Agreement.

I understand that by executing this document, I am giving up forever all right, title and interest to such Cairn, and that all future decisions regarding the placement of this animal will be made solely by Cairn Rescue. I also understand that if this Cairn is later found to have such an unpredictable temperament as to be unsuitable for any placement, or if the Cairn's quality of life is substantially impaired, in the opinion of a competent veterinarian, by a chronic, irreversible and/or painful condition, Cairn Rescue may consider euthanasia as a final alternative to adoptive placement.

I represent and warrant that the information provided on Parts I and II of this Agreement is the truth to the best of my knowledge and belief and agree (jointly and severally if this Agreement is executed by more than one owner) to hold Cairn Rescue, its officers, directors, representatives and volunteers, and any other group or organization that may place this Cairn in reliance on the information provided in this Agreement, harmless from any loss or injury resulting from any false information or misrepresentations that I may have submitted or made in this Agreement.

I further represent and warrant to Cairn Rescue, its officers, directors, representatives, and volunteers, that I (and if applicable, any other signatories to this Agreement) (i) am/are the sole owner(s) of this Cairn (ii) have full power and authority to surrender this animal for adoption (iii) am/are the only person(s) listed as the registered owner(s) of this animal with the AKC (if said Cairn is registered).

If the Cairn is AKC registered and I have indicated in Part I that I am able to provide AKC Registration Papers for the Cairn to Cairn Rescue, I agree to deliver to Cairn Rescue a properly signed transfer of such AK registration papers, omitting the name of the transferee, and hereby designate and authorize Cairn Rescue as my agent and attorney-in-fact for purposes of designating a transferee and inserting this name on the AKC registration form.

Please make sure the application is complete before pressing the "Submit" button below. Incomplete applications may be rejected or delayed.






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PLEASE NOTE: the use or duplication of this form is expressly prohibited without written permission from ggreyfriar@aol.com if the entity is not associated or affiliated with Col. Potter Cairn Rescue Network.

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Last Update: 25-July-2005
Copyright © 2001-2005 Col. Potter Cairn Rescue Network
"Cairn at the Computer" Artwork Copyright © 2000 Ann Priddy
Web Developer: Veronica A. Hudak-Moe