Release of Ownership Questionnaire

Release of Ownership

When someone initially contacts CHAAMP, they do not sign the Release of Ownership form. The owner signs and dates in the presence of a CHAAMP representative only after CHAAMP has agreed to take the Dog. We are happy to discuss options with you.
I, First Name Last Name , certify that I am the legal owner of the Alaskan Malamute named below (hereinafter known as "Dog"), and as owner, I hereby give and release the Dog named below to Chesapeake Area Alaskan Malamute Protection (CHAAMP). I hereby transfer full and complete ownership of, exclusive rights to, decisions about, and responsibility for this Dog as of this date, Date .

I certify that the information I have provided below is the truth. I understand that I no longer have control over, rights to, ownership, or responsibility of this Dog and that CHAAMP will do with this Dog as it deems fit, including adopting the Dog to a qualified family, kenneling the Dog, fostering the Dog with an appropriate family, or euthanizing the Dog if necessary for temperament reasons.

I understand that I will not be given the contact information of the Dog’s adoptive or foster family, nor will I attempt to find or visit the Dog at any time from this day forward.

I understand CHAAMP will give me updates on the Dog upon my request, only if the new owner agrees. CHAAMP never discloses the location or the name of the new owner.

Owner Signature: _____________________________________
Date:

CHAAMP accepts the Dog: ____________________________________
Date:

The owner signs and dates in the presence of a CHAAMP representative only after CHAAMP has agreed to take the dog. Provide vaccine records, especially for rabies.
OWNER's INFORMATION
Owner Legal Name *

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Where we can reach you.
DOG's INFORMATION
Dog's Name*
Dog's sex*
Dog's weight*
in pounds
Dog's Date of Birth *
Please let us know exact date or your best estimate
How old was the Dog when you got him/her?*
You can guess if you don't know.
Does the dog have an AKC, chip type/number, tattoo number? *
Please include the number.
Dog's Coloring
The usual colors range from light gray through intermediate shadings to black, sable, and shadings of sable to red. There is also white.
Where did you get this Dog? (Please provide name of breeder, pet store, previous owner?)*
Kindly provide any history of the Dog. If Dog comes from a breeder, please check your contract as you may be legally required to return the Dog to the breeder.
Please attach current photos of the Dog

Cancelof
CIRCUMSTANCES FOR SURRENDER
Why are you giving up this Dog?*
Explain the circumstances and let us know if you wish assistance to keep the Dog.
Does the Dog need to be removed immediately or are you able to foster the Dog while we find a home?*

Remove as soon as possibleRemove within a few weeksCan stay until a home is foundOther
What type of home environment would best suit this Dog?*
Based on your knowledge, describe the ideal home for the Dog.
MEDICAL RECORDS
Please provide name of Veterinary Practice, Vet who has seen Dog, and phone number.*
Please contact your vet and give them permission to speak with a CHAAMP volunteer.
Is the Dog up to date on vaccines? (Click on all that apply)*

Rabies (legally required)Parvo (core vaccine)Distemper (core vaccine)Bordatella (prevents kennel cough)Lepto (Leptospirosis can be transmitted from a dog to a human)Not current on vaccinesOther
What is the date of the last Heartworm Test (performed on an annual basis).*
If not up to date, please state that here.
If Dog is NOT up to date on Vaccines and/or Heartworm Test, are you able to update before surrendering?

Yes, I can get the Dog up to date prior to surrenderingNo, I am unable to financial afford veterinary care for the dogI can make a donation to help with expensesOther
List supplements and medications. Are there medical or health issues or concerns?
We want to provide for the health of the Dog appropriately. Your response does NOT affect whether we can accept the Dog.
Upload Vet Records & Rabies certificate

Cancelof
ABOUT THE DOG

There are no wrong answers. Malamutes can be very passionate about their needs and wants. We need to understand the Dog's structure, capabilities, and sensitivities. Our goal is to keep him safe and do our best to maintain Dog’s routine as close as possible to minimize stress.
List the Dog's brand of dogfood, treats, food, and the feeding schedule.*
Help us know the dog's favorite foods :)
Explain the Dog's current potty schedule. What phrase do you use to go potty? Or does the dog need to be potty trained?*
We have dogs that are not potty trained, this is not an issue. Many store bought dogs have difficulty with learning to be potty trained.
Where does the Dog stay at night? Check all that apply.*

Inside - free reign of the houseInside the bedroomInside the crateInside the baby gateInside on the sofaOutside kennel/penPrefers outside in the cold weather (common with Malamutes)Outside yardOther
Does the Dog jump fences?*

YesNoSometimesOther
What is the height of the fence the Dog can jump?
Please explain the circumstances and describe the fence height. This will help us the Dog safe and secure :)
Does Dog howl or bark excessively? If so, explain the circumstances.
If separation anxiety is suspected, we will need to provide additional support to prevent the Dog from experiencing distress.
RESOURCE GUARDING

Resource guarding is a natural behavior. Malamutes tend need “space” when eating and some do not like to share toys or display behavior such as growling, snapping to keep pets and humans away from a resource. How would you react if a stranger or family member put their hands on your steak? Some dogs growl (valuable warning communication) or escalate to lunging and biting. We want to understand the Dog's sensitivities.
Check all that apply to describe Dog's need for "space" and the response.*

FoodToysCrateBedHumansWater bowlTreats, Chews, Kongs, etc.Resource Guarding is UNPREDICTABLEResource Guards by WALKING AWAY or BRINGING ITEM CLOSER TO BODYResource Guards by GROWLING to warn you to keep your distanceResource Guards by LUNGING and BARKING if you are too closeOther
Context matters, please explain CIRCUMSTANCES for resource guarding. We want to be respectful of their space and not upset the Dog. *
Generally speaking, Malamutes prefer to eat treats or meals in their own space. They can also be passionate about their food when other dogs are close.
DOG's LIKES & DISLIKES

It is important to learn about the Dog so we can prepare and do our best to support the transition.
Check any that apply:*

Likes to fetchLikes to swimLikes car ridesLikes toysLikes to digLikes to play tugLikes to chew non-toy itemsJumps on peopleGenerally social with peopleNervous in the carHowls or barks when left aloneNoise sensitivityLikes to demand bark for food - a Malamute favorite!High energy dog - active, hiking, candidate for dog sportsLow energy dog - happy couch potato with regular walks AM/PMFood motivatedLikes to chase critters which is normal for a Malamute!Likes to sleep on the sofaLikes to sleep on the bed with their humanLikes to snuggleEnergetic in the morning and evening; sleeps during the dayOverall likes to pull on leash (common for Malamutes - they were born to pull!)Good on leash EXCEPT around wildlife or catsThunderstorms are upsettingGood on leash EXCEPT around small dogsGood on leash EXCEPT around certain dogsGood on leash EXCEPT when meeting people
Explain what the Dog likes or dislikes with context.
This information is used to HELP us learn about the Dog.
Dog's personality is:*

Friendly with most strangersNervous / needs time to warm upPlayful / outgoingCalm and relaxedEasily distracted (squirrel!)Shy / easily frightenedA bit anxiousPrefers to avoid peopleDoes NOT like strangers in the homeDoes NOT like meeting new peopleNeeds proper introductions before a stranger can come insideOther
Please provide context and explain the Dog's personality from question above.
We understand the circumstances might affect the Dog's response.
The dog is generally comfortable with:*

Adult menAdult womenTeenagersChildrenInfantsIt depends!Other
Dog's experience with children*

Dog is scared of children (too loud and unpredictable)Loud children are scaryDog is gentle with childrenDog likes some but not all childrenDog lunges at childrenDog has NO EXPERIENCE with children
Do you think the dog will do well in a home with baby, child(ren), or teens? Yes/No? Explain Dogs reactions and experiences. *
Due to a Malamutes size and personal preference, some do well with children, some are large and goofy and might accidentally knock over a child, and some prefer to stay away from children. There is no wrong answer. Some families have toddlers, infants, teens -- we want to know the Dog's preference to find a suitable home.
Grooming - the dog:*

Tolerates bathsDoes NOT like bathsTolerates nail clippingsTolerates clippersTolerates the nail grinderDoes NOT like paws touched (common for Malamutes)Likes being brushedDoes NOT like being brushedDoes NOT like the doggy blow dryerTolerates the doggy blow dryer
Has the Dog ever been in a boarding facility? Did the Dog do ok?
Good to know if they are used to boarding.
TRAINING & COMMUNICATION

Describe the Dog's training and your communication style. We want to understand the Dog's baseline and what the Dog knows.
Dog knows the following cues (commands):*

SitDownComeStayHeelDog went to a board and train and knows lots of commandsNo training experienceMinimal training
Describe training methods and training equipment used with Dog so we have a baseline of the Dog's experience. *
For example, use of a prong/choke collar to prevent pulling or a shock collar to keep Dog from escaping. There is no wrong answer. We want to understand the communication style used with the Dog.
DOG's INTERACTIONs WITH OTHER PETS

Describe the Dog's training and your communication style. We want to understand the Dog's baseline and what the Dog knows.
Are there other pets in the home (cats, dogs, bird, etc.)? Explain how the Dog interacts with the pets. Do you think the Dog would like to live with another dog?*
This will help us place the Dog in an only 1 dog home or with another dog or cat. Malamutes can be picky about canine friends and some would like the company. Let us know what you think? We have adopters that have cats and we want to know if the Dog is a potential candidate.
How does the Dog react with other dogs?*

Generally Dog is friendly with other dogsFriendly with small dogsAggressive with small dogs (common for Malamutes)Generally dog aggressive (lunging, barking)Same sex aggression (common with Malamutes)Reactive with other dogs - prefers distance (common with Malamutes)Prefers to avoid other dogsHad a bad experience with a dog so avoids all dogsDog selective, it depends (some people are the same way too and that is ok!)Other
Explain how does the Dog meets other dogs, or if you avoid other dogs?
Helps us understand how the dog reacts when meeting other dogs. Some dogs are much better meeting another dog behind a fence or as simple as walking together before play. Some dogs prefer distance and avoidance. We want to know what works best for the Dog. Malamutes often need time for successful first interactions depending on their level of arousal, and personality in general.
Reaction to cats?*

Aggressive with cats (hunting genetics - predation behavior)Cat friendlyOnly friendly with cat in current homeUnknown?Other
BITE HISTORY

Malamutes generally tend to have big feelings, easily aroused, sensitive about the "space" and having their rear and paws touched. They are so beautiful to look at (stare); and so fluffy that people want to hug. They can be so animated that often we miss their warnings. This combination often puts them in bad situations.
Has the Dog ever nipped at you? If yes, please explain the circumstances BEFORE the nip occurred. (A nip can be an air snap or when the teeth touch or scratches the skin. It's their way of saying, "Enough!!!" If a dog wants to bite you, they will).*
Please let us know what NOT to do with the dog. Thanks!
Check any that apply to describe the level of the dog contact/bite using Dr. Ian Dunbar's Dog Bite Scale.*

Level 1 (Obnoxious, aggressive behavior but no skin contact)Level 2 (Skin-contact but no skin puncture)Level 3 (One to four punctures from a single bite with no puncture deeper than half the length of the dog’s canine teeth.)Level 4 (One to four punctures from a single bite with at least one puncture deeper than half the length of the dog’s canine teeth.)Level 5 (Multiple-bite incident with at least two Level 4 bites)Not Applicable or unsure how to answer this question
Please explain the circumstances that led to the bite? Was the Dog quarantined? If so, with which authority? Are you willing to work on behavior modification with the Dog prior to surrendering him/her?
Can we offer assistance on behavior modification? We highly recommend Michael Shikashio, https://aggressivedog.com/
Has the Dog been in a dog fight? Please explain the circumstances. Did the Dog bite the other dog or get bit?
Can we offer assistance on behavior modification? We highly recommend Michael Shikashio, https://aggressivedog.com/
*** When someone initially contacts CHAAMP, they do not sign the Release of Ownership form. The owner signs and dates in the presence of a CHAAMP representative only after CHAAMP has agreed to take the dog. ***
Should be Empty:

Release of Ownership

OWNER's INFORMATION

DOG's INFORMATION

CIRCUMSTANCES FOR SURRENDER

MEDICAL RECORDS

ABOUT THE DOG

RESOURCE GUARDING

DOG's LIKES & DISLIKES

TRAINING & COMMUNICATION

DOG's INTERACTIONs WITH OTHER PETS

BITE HISTORY