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<br /> <br />ANIMAL SERVICES <br /> <br />1601 Eubanks Road http://orangecountync.gov/animalservices phone: (919) 942-7387 <br />Chapel Hill, NC 27516 fax: (919) 918-2393 <br /> <br />ADDENDUM TO FOSTER CONTRACT <br /> NOTIFICATION OF SPECIAL MEDICAL CONDITIONS <br /> <br />_____________________ <br />FOSTER: __________________________ <br />ANIMAL ID: __________________________ <br /> <br />I, the Foster Volunteer, affirm that Orange County Animal Services (OCAS) <br />staff has explained to me that the animal I am fostering has been diagnosed with heartworm disease by the <br />shelter’s medical staff. By my signature below, I affirm that I have read and understood this document, <br />including the following information regarding the medical abnormalities and treatment of the dog I am <br />fostering: <br /> <br />1. Orange County Animal Services will provide the initial treatment for the heartworms as described below <br />at no cost to you. As part of the treatment process, OCAS agrees to the following (applicable items will <br />be initialed by a member of OCAS management): <br /> <br />o Provide 30 days of antibiotic treatment with Doxycycline that must be completed prior to the <br />heartworm treatment. <br /> <br />_______ The shelter’s medical staff began the course of treatment with Doxycycline, but it has not <br />yet been completed. OCAS is sending you home with the balance of that medication along with <br />instructions for its administration. <br /> <br />_______ The shelter’s medical staff completed the course of treatment with Doxycycline while the <br />pet was in the custody of OCAS as documented in the copy of the shelter medical record you have <br />been provided. <br /> <br />o Provide a series of injections with Immiticide that are intended to kill the adult heartworms. <br /> <br />_______ The Immiticide injections have not yet been completed. You will need to return the <br />animal to OCAS in accordance with the schedule outlined below for this portion of the treatment. <br /> <br />_______ The shelter’s medical staff completed the course of treatment with Immiticide while the <br />animal was in the custody of OCAS as documented in the copy of the shelter medical record you <br />have been provided. <br /> <br />o Consult with your regular veterinarian as needed to discuss the case. Feel free to have your <br />veterinarian contact Veterinary Health Care Manager Jasmine Johnson at <br />jajohnson@orangecountync.gov <br />