Custom Component or Customizing of Existing Component

We need a component that shows videos (VHS and DVD's) that are available and allows the user to request to check out the video. There is no charge for customers checking out the videos so we would not need a shopping cart or payment processing. However, we would like the requests to go through a currently installed component, RSFORM. So, when the user clicks "request" to check out a particular video, the VIDEO ID or SKU, and title get automatically passed to and populated in the form. Currently we are using a component called FILE CABINET to display the videos. However to use this component for this purpose some modifications to the code would be necessary. Also, we are using FILE CABINET in another part of the site, so if that were the component we used for the videos, it would need to be cloned somehow so the changes did not effect the other instance of the component. Perhaps other programmers have a better solution than what I have suggested? If so, we look forward to hearing from you. The developer with the most effective solution will be chosen. As long as it works the way we need it to, we're open to suggestions. Mock-up of video requests page is attached.