DD Form 3076-1 "Military Working Dog (Mwd) Adoption Suitability Checklist"

What Is DD Form 3076-1?

This is a form that was released by the U.S. Department of Defense (DoD) on October 1, 2019. The form, often mistakenly referred to as the DA Form 3076-1, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Editable, printable, and free to use;

Download an up-to-date fillable DD Form 3076-1 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

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Download DD Form 3076-1 "Military Working Dog (Mwd) Adoption Suitability Checklist"

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FOR OFFICIAL USE ONLY UPON COMPLETION
Military Working Dog (MWD) Adoption Suitability Checklist
MWD Name:
Tattoo:
PURPOSE: This checklist is to be used by the Accountable Unit Commander (AUC) to assist in making an initial determination of the suitability of an excess MWD for adoption. The
checklist is completed by the MWDs Handler in consultation with the unit's Kennel Master/Training Team Leader and the Veterinary Corps Officer (VCO) supporting the AUC prior to
review and completion by the AUC.
Handler / Kennel Master / Team Leader
Yes
No
*
Attending VCO
Yes
No
*
1. Have you conducted a physical exam on this
1. Have you observed this MWD's behavior?
MWD within the past 6 months?
2. Does this MWD have a history of being overly-
2. Does MWD have a severely debilitating
aggressive or territorial towards people?
condition or one that threatens life/limb?
3. Does this MWD have a history of biting people
3. Does MWD have moderate to severe pain that
without obvious provacation?
cannot be managed medically?
4. Does MWD medical records indicate a history
4. Is this MWD tolerant around strangers?
of aggressive behavior problems?
5. Can different handlers easily handle this MWD
5. Has MWD demonstrated aggression toward
using voice commands and physical controls?
handlers?
6. Is this MWD aggressive toward its own handler
6. Has MWD shown aggression towards persons
(e.g. does it"come up leash")?
other than a decoy/suspect?
7. Are there any circumstances in which the MWD
7. Does this MWD display aggression when
responds with unexpected, inappropriate, or
threatened by humans?
unpredictable behavior?
8. Are there any particular settings in which the
8. In your opinion, will this MWD be suitable going
MWD responds with unexpected, inappropriate,
to a family with children?
or unpredictable behavior?
9. Does this MWD display aggression towards
9. Is this MWD a danger to itself or others
children?
because of moderate to severe aggression?
10. Is this MWD overly-aggressive toward or in
10. Does this MWD have any behavioral
the presence of other dogs or animals other than
problems (other than aggression) that may
dogs (e.g. is it a "dog fighter")?
require ongoing care?
11. Does this MWD show obvious distress and/or
attempt to escape/avoid situations in which it is
11. In your opinion, will this MWD be suitable
exposed to loud noises (i.e. gunfire, thunder,
going to a family with children?
fireworks)?
12. Does this MWD show aggressive behavior
12. Does this MWD show obvious distress and/or
directed toward its handler when exposed to loud
attempt to escape/avoid during veterinary
noises (i.e. gunfire, thunder, fireworks)?
examination or treatment?
13. Is this MWD aggressive when taken out or put
13. Does this MWD become aggressive during
back into its run or kennel?
veterinary examination or treatment?
14. Is this MWD aggressive when retrieving its
14. Is this MWD aggressive when taken out or put
reward or toy?
back into its run or kennel?
15. Does this MWD display aggression around
15. Does this MWD display aggression around
food - when food delivered, during feeding, or
food - when food delivered, during feeding, or
when retrieving food pan?
when retrieving food pan?
NOTE: A response of * abover means that the respondent cannot answer the question "yes" or "no" based on information
available - discuss in "Comments" section
Comments:
Handler/Kennel Master/Team Lead
Attending VCO
Printed Name:
Printed Name
Telephone:
Telephone:
Email:
Email:
Signature:
Signature:
Accountable Unit Commander Review
After review of this checklist and consultation with the unit Kennel Master and attending VCO, my preliminary determination is that this MWD is/is not a candidate
for adoption (circle one)
Signature:
Date:
Printed Name:
Telephone:
Email:
DD FORM 3076-1, OCT 2019
Page 1 of 1
PREVIOUS EDITION IS OBSOLETE.
FOR OFFICIAL USE ONLY UPON COMPLETION
FOR OFFICIAL USE ONLY UPON COMPLETION
Military Working Dog (MWD) Adoption Suitability Checklist
MWD Name:
Tattoo:
PURPOSE: This checklist is to be used by the Accountable Unit Commander (AUC) to assist in making an initial determination of the suitability of an excess MWD for adoption. The
checklist is completed by the MWDs Handler in consultation with the unit's Kennel Master/Training Team Leader and the Veterinary Corps Officer (VCO) supporting the AUC prior to
review and completion by the AUC.
Handler / Kennel Master / Team Leader
Yes
No
*
Attending VCO
Yes
No
*
1. Have you conducted a physical exam on this
1. Have you observed this MWD's behavior?
MWD within the past 6 months?
2. Does this MWD have a history of being overly-
2. Does MWD have a severely debilitating
aggressive or territorial towards people?
condition or one that threatens life/limb?
3. Does this MWD have a history of biting people
3. Does MWD have moderate to severe pain that
without obvious provacation?
cannot be managed medically?
4. Does MWD medical records indicate a history
4. Is this MWD tolerant around strangers?
of aggressive behavior problems?
5. Can different handlers easily handle this MWD
5. Has MWD demonstrated aggression toward
using voice commands and physical controls?
handlers?
6. Is this MWD aggressive toward its own handler
6. Has MWD shown aggression towards persons
(e.g. does it"come up leash")?
other than a decoy/suspect?
7. Are there any circumstances in which the MWD
7. Does this MWD display aggression when
responds with unexpected, inappropriate, or
threatened by humans?
unpredictable behavior?
8. Are there any particular settings in which the
8. In your opinion, will this MWD be suitable going
MWD responds with unexpected, inappropriate,
to a family with children?
or unpredictable behavior?
9. Does this MWD display aggression towards
9. Is this MWD a danger to itself or others
children?
because of moderate to severe aggression?
10. Is this MWD overly-aggressive toward or in
10. Does this MWD have any behavioral
the presence of other dogs or animals other than
problems (other than aggression) that may
dogs (e.g. is it a "dog fighter")?
require ongoing care?
11. Does this MWD show obvious distress and/or
attempt to escape/avoid situations in which it is
11. In your opinion, will this MWD be suitable
exposed to loud noises (i.e. gunfire, thunder,
going to a family with children?
fireworks)?
12. Does this MWD show aggressive behavior
12. Does this MWD show obvious distress and/or
directed toward its handler when exposed to loud
attempt to escape/avoid during veterinary
noises (i.e. gunfire, thunder, fireworks)?
examination or treatment?
13. Is this MWD aggressive when taken out or put
13. Does this MWD become aggressive during
back into its run or kennel?
veterinary examination or treatment?
14. Is this MWD aggressive when retrieving its
14. Is this MWD aggressive when taken out or put
reward or toy?
back into its run or kennel?
15. Does this MWD display aggression around
15. Does this MWD display aggression around
food - when food delivered, during feeding, or
food - when food delivered, during feeding, or
when retrieving food pan?
when retrieving food pan?
NOTE: A response of * abover means that the respondent cannot answer the question "yes" or "no" based on information
available - discuss in "Comments" section
Comments:
Handler/Kennel Master/Team Lead
Attending VCO
Printed Name:
Printed Name
Telephone:
Telephone:
Email:
Email:
Signature:
Signature:
Accountable Unit Commander Review
After review of this checklist and consultation with the unit Kennel Master and attending VCO, my preliminary determination is that this MWD is/is not a candidate
for adoption (circle one)
Signature:
Date:
Printed Name:
Telephone:
Email:
DD FORM 3076-1, OCT 2019
Page 1 of 1
PREVIOUS EDITION IS OBSOLETE.
FOR OFFICIAL USE ONLY UPON COMPLETION