Rescue Partner Information and Application
Thank you for your interest in partnering with The Erin H Helping Paws Good Samaritan Fund, provided by Westerville Veterinary Clinic. Your efforts to join with us in support of the animals in our community are greatly appreciated! By becoming a Rescue Partner, we will save lives together!
Our Mission: Our mission is to improve the lives of as many animals as possible, while simultaneously supporting our community, through low-cost sterilization, vaccination, and wellness services.
What We Do: The Erin H Helping Paws Good Samaritan Fund assists both owned animals, as well as those currently being cared for by local shelters and rescues, through a variety of veterinary services, including:
· Operating low-cost canine and feline vaccine clinics for owned animals
· Operating low-cost spay and neuter clinics for owned animals
· Providing emergency veterinary relief for families in need
· Providing low-cost dental services to shelters and rescues
· Providing low-cost canine and feline vaccination services to shelters and rescues
· Providing low-cost spay and neuter services to shelters and rescues
· Providing low-cost miscellaneous soft tissue surgical services to shelters and rescues
· Operating a small-scale foster program
· Operating a small-scale in-house sheltering program
How to Become a Rescue Partner1. Complete the Rescue Partner Agreement Application, below. Must be reviewed and signed by your organization’s designated representative (Director/President/Board Member/etc.) before moving forward;
2. Provide copy of 501(c)(3) status, if applicable;
3. Review and approval can take up to 7 business days. You will receive status notification via email or regular mail (as applicable). The notification will include copies of related correspondence for your records.
Again, thank you for your interest and participation in this worthwhile program and for helping us help them!
If you have any questions, feel free to contact Breona at email@example.com.
ParametersTo help our staff work more expeditiously with you, we ask that you identify for us any particular parameters you may have when it comes to acceptance of an animal into your program. As an example: Many shelters and rescues will accept any animal; some accept only a specific breed and may accept clear crosses of that breed. Others may have specific requirements (less than three years old; weigh not more than XX pounds; no injuries; etc.
Authorized ContactsBy completing this section, you are authorizing the individuals named below to:
Act on your organization's behalf, including authorizing treatment plans and transactions, and/or transport animals between your organization's facility and our facility, on your organization’s behalf under the Rescue Partner Agreement. This information will be entered into our database for reference. We will ensure that only those individuals you authorize will be able to transport animals from our facility under your organization’s name. All information is confidential and is for departmental use only. Please select the shelter preferences, below, and use the definitions provided for reference. Primary Contact: Can authorize treatment plans and/or transactions, as well as transport animals between your organization's facility and our facility. Transporter Only: Is only responsible for bringing animals to our facility; is not authorized to transport animals from our facility. Authorized Exit: Can transport animals to and from our facility.
If you have selected 'No,' payment will be required at the time of services.
Notification will be given by email, 24 hours prior to processing a transaction via the card left on file. Special arrangements can be made for substantial balances incurred by patients requiring extensive care, but the request must be submitted in writing to Breona@westervillepets.com prior to seeking care for the patient.
I, Your Name Here, designated representative of Your Organization Name, agree to the following terms, limitations and conditions of the Rescue Partner Agreement provided by the Erin H Helping Paws Good Samaritan Fund, via Westerville Veterinary Clinic. I, the designated representative of my organization, understand that, if we are found to be in knowing violation of any of the below conditions at anytime, the Erin H Helping Paws Good Samaritan Fund reserves the right to suspend and/or terminate our relationship. By signing this form, I acknowledge that I have read, understand, and agree to each of the following:
a. The EHHP Good Samaritan Fund and partners will clarify and respect proper chain of command for efficient communication.
b. Questions and concerns will be welcomed by both parties, according to the agreed upon chain of command.
c. Questions and concerns will be presented respectfully and responses will be prompt and equally respectful.
d. The EHHP Good Samaritan Fund and partners will consider the impact of their public discourse and each other and will consider input that is in the best interest of the partnership. Unprofessional or negative public discourse, in venues such as online posting, may be grounds for cessation of partnership.
The Rescue Partner identified below acknowledges receipt of the above policies and agrees to be bound by them.
To be signed only by the designated representative within the rescue organization.