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Equine Donation Request Form
This is a request form for the donation of the below-described Equine for placement in an adoptive home by Rowley Rescue Ranch
Once this form has been submitted you will be contacted by a Rowley Rescue Ranch representative to proceed to the next steps.
Transportation of equine to the rescue in Nixa, MO 65714 must be arranged and paid for by the owner.
We do not require a surrender fee, but donations are always appreciated to better help your equine find a new home.
Equine must must meet the following criteria to be considered for admission:
Equine is under 26 years old
Horses and Ponies must be at least light riding sound.
Equine does not have a long term health condition that will shorten his or her life or render them only pasture sound.
We do not accept stallions or stud colts.
*Please fill out one form per equine if requesting to donate more than one.
*
Indicates required field
Owner's Name
*
First
Last
Email
*
Horse's Location/ Address
*
Phone Number
*
Do you have a trailer to transport horse to our facility?
*
Equine's Name
*
Breed
*
Equine's Registered Name
*
Age
*
Gender
*
Reason for surrendering the equine?
*
If the Equine is a mare, is there any possibility she could be pregnant?
*
Yes
No
Is the equine rideable?
*
Yes
No
If so, what discipline?
*
Has this Equine ever received any professional training?
*
Yes
No
If so, what type of training and for how long?
*
Has the equine ever had a significant injuries, lameness that affected his ability to be ridden, or surgery?
*
Yes
No
If yes, please explain
*
Has this Equine ever injured anyone
*
Yes
No
If yes, please explain the circumstances:
*
Does this Equine have any habits that may create harm to other horses or people or cause damage to the facility or other property (e.g., kicks, bites, rears, bucks, cribs, etc.)?
*
Yes
No
If yes, please explain the circumstances:
*
Please list the dates of the Equine’s last vaccinations, worming, hoof, and dental care:
Tetanus
*
Flu-Rhino
*
Rabies
*
Hoof Care
*
Worming and Product
*
E&W Encephalomyelitis
*
West Nile Virus
*
Negative Coggins Test
*
Dental Care
*
Sheath Cleaning (if Gelding)
*
If the Equine has not been vaccinated
and has a negative coggins test
in the
current calendar year, please vaccinate the equine and test for coggins before donating and provide copies of
these records to Rowley Rescue Ranch.
Has this Equine demonstrated symptoms of or been exposed to any contagious conditions within the last 45 days?
*
Yes
No
If yes, please explain:
*
Does this Equine have any medical conditions restricting its feed, bedding, turnout, or any other care or maintenance? (e.g., founder, EPM, allergies, etc.)
*
Yes
No
If yes, please explain:
*
Is this Equine accustomed to living in a stall?
*
Yes
No
If no, please explain:
*
Does this Equine stand easily for the farrier?
*
Yes
No
If no, please explain:
*
Does this Equine stand easily for the veterinarian?
*
Yes
No
If no, please explain:
*
Does this Equine load on a trailer easily?
*
Yes
No
If no, please explain:
*
Thank you so much for taking the time to fill out our Equine Donation Request Form. A member of our team will be in contact with you shortly to review your form and arrange a delivery appointment if approved.
Submit
Make a Difference
Please take a moment to consider gifting a vital donation to help horses in need.
Your contribution today helps us continue our important work to help rescue, rehabilitate, retrain and rehome over 50 horses a year
Donate
DROP US A LINE
Rowley Rescue Ranch
Facility Location: Nixa MO 65714
(573) 381-0883
Rowley Rescue Ranch is a 501(c)(3) non-profit equine welfare organization.
Tax ID #88-1495183
All donations are tax deductible.
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