Registered Foundation No: 175647065

Rudozem Street Dog Rescue

Help us to help them

English Questionnaire  -  UK Adoption Team

Thank you for showing an interest in adopting a rescue dog from Rudozem Street Dog Rescue. It is our policy to make sure that each person who adopts

a dog is aware of the responsibilities of owning a dog, and is capable of and willing to accept those responsibilities morally, physically and financially.  
Please read the articles on our adoption page.  By completing this questionnaire, you will help us to determine if the dog you are interested in is suited to your family and situation. 


By adopting a dog from Rudozem Street Dog Rescue, you are helping to save the life of a dog which may have suffered abuse, hardship or would have died on the streets. Each Adopter is asked for a contribution towards the cost of transport. The contribution does not cover all the costs incurred, but helps ensure RSDR continue to do their rescue work in saving and caring for more street dogs.


Please complete the questionnaire below, and press submit.

UK QUESTIONNAIRE
Questions marked by * are required. Please note: If you are applying to adopt a cat, some questions may not be relevant so please put NA next to those questions.
1. Name of Dog(s) or Cat(s) you are interested in adopting? *
2. Title (eg. Mr, Mrs, Ms, Miss etc).
3. Please list First & Last Names of all adult persons(s) over 18 years old, in the household adopting an RSDR animal. *
4. Age(s):
5. Email Address: *
6. Alternative Email:
7. Your facebook Profile URL:
8. Website Address (optional):
9. Street Address: *
10. Town/City: *
11. State/County: *
12. Postcode / Zipcode: *
13. Country of Residence *
14. Country of Birth:
15. What languages do you speak?
16. Home Phone Number:
17. Work Phone Number:
18. Mobile Phone Number:
19. Passport / License Number:
20. Copy of Photo ID with current address, either upload by pressing on the below button, or email scanned copy to rsdrukadopt@gmail.com
21. If your photo ID does not show proof of current address (A telephone, utility or cable television or similar bill qualifies) Please upload by pressing on the below button or email to rsdrukadopt@gmail.com
22. Occupation:
23. Do you work:
  • Fulltime
  • Part-Time
  • Casual
  • Retired
  • Self Employed
24. How many hours do you work daily/week?
25. Do you have children in the family or children that regularly visit? (under 18 years of age)
26. If yes, please enter the ages and sex of the children.
27. Do all members of the family agree with the adoption of the dog or cat?
28. How did you hear about Rudozem Street Dog Rescue?
  • Internet search
  • Facebook
  • Dogs Blog Website
  • Pets 4 Homes Website
  • Rescue Search Website
  • Print/Flyer Advertisement
  • Word of Mouth
  • Other
29. Other way you heard about RSDR?
30. Type of Dwelling?
  • House
  • Apartment
  • Other
31. Other type of dwelling?
32. Do you own or rent your dwelling?
33. If rented, do you have your landlords permission to have a cat or dog, and are you able to provide a written copy of your lease or provide written permission from your landlord?
34. Please upload a copy of your attachment of rental written agreement by pressing the below button, or email the agreement to rsdrukadopt@gmail.com
35. Please explain more about your dwelling? Is it a one storey building, or two? Does it have stairs?
36. Do you have a yard or garden?
  • Yes
  • No
37. Explain about your yard/garden. Example: Size of garden, is it a town garden, large property pasture, etc.
38. Is your garden/yard fenced?
  • Yes
  • No
39. What is the height of your fence? What type of fence?
40. Do you currently have any dogs?
  • Yes
  • No
41. If no, have you previously had one or more dogs?
42. If you currently have dogs, please provide details. Example: Age, gender, type, personality. Where did you get them from?
43. Are they neutered and have current up to date vaccinations?
44. Have you ever had to give up a dog for any reason?
  • Yes
  • No
45. If yes, please explain why you had to give the dog up?
46. Do you have any other animals?
  • Yes
  • No
47. Please share details of your other pets:
48. Has any member of your family ever experienced animal related allergies?
49. Who would be responsible for the care of the dog/cat?
50. Would the dog be left alone during the day on a regular basis?
  • Yes
  • No
51. If yes, for how many hours per day?
52. If the dog is left alone for more then 4 hours a day, are you able to arrange someone to look after the dog, daycare or dog walking or similar?
53. Would the dog live indoors with you?
54. If you have a dog currently where does it sleep? Inside or Outside? Describe its sleeping arrangements.
55. Are you able to provide your dog with regular exercise?
56. If you go on holidays, do you have someone to look after the dog or would they go in a kennel?
57. Are you prepared to take the dog to dog training classes for basic obedience and socialisation?
58. If you are experiencing behaviour / obedience problems with your puppy / dog, would you be prepared to go and see a behaviourist?
59. If you are adopting a cat, would the cat be an indoors cat or have a cat enclosure, or would it be allowed in the garden?
60. Will the animal be insured?
61. Name of Veterinarian:
62. Veterinarians Address:
63. Vets Phone Number / Email Address and Website:
64. (Optional) Letter of Reference from your vet. (please upload or email to rsdrukadopt@gmail.com)
65. Are you able to provide car transport to the meeting venue to collect your dog / cat?
66. Please tell us why you would like to adopt a dog or cat from RSDR?
67. Do you have any questions or comments about the dog or cat you are wanting to adopt?
68. What are the best times to contact you by phone?
69. Do you agree to a representative of the foundation occassionally contacting you, and if in the area, a home visit, and would you keep us informed of the dogs or cats welfare with regular updates with photos or videos?
  • Yes
  • No
70. Do you agree to allow RSDR to use any photos/videos in updates of adopted animals by email/facebook to use on their website & social media to help with promoting RSDR?
  • Yes
  • No
71. Questionnaire Information:

Agree Disagree