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Name of animal you are adopting*
Choose an animal: Akira Bandit-SB Brock Captain Jack-SB Celeste Copper Cullen Daphne Dexter bonded with Lexi (must be adopted with Lexi bonded with Dexter and Lexi bonded with Dexter) Dusty-SB Feliz-SB Fern Finn Garvey Happy-SB Helena Hercules Howie Irene Izzy James Kitty- SB Ladie Lexi bonded with Dexter (must be adopted with Dexter bonded with Lexi and Dexter bonded with Lexi) Liam Lupon Maddie Maddox-SB Madison Maeve-SB Maisie- SB Maximus-SB Meena- SB Miss Priss- SB Mitch Mora Morgan- SB Ollie Otis Ottilie Otto Panther Pinto Bean- SB Radish Riley Rose Ruby Sam Scout-SB Sir Kingsley Sophie Summer Sunshine- SB Terrie Theo Tucker Winkie

If your dog was not listed in the drop down box, please fill in the name of dog you are adopting:*

Please list your veterinarian's Name, Address and phone number below*

Veterinarian's Phone Number*

I have been told that my adopted dog has tested HW+ and I have had the “Slow-Kill Treatment Protocol” explained to me, along with the name & contact information for the Great Pyrenees Rescue Society’s Heartworm Positive medical coordinator.

I agree to follow the treatment guidelines of the “slow-kill treatment protocol” and have discussed this with my vet, who will support me in this treatment plan.

I agree to stay in contact with the rescue, and specifically with the HW+ coordinator, to request more medications as needed (which the rescue will provide) and to give status updates on my dog’s HW treatment plan.

I understand that the “Slow-Kill Treatment Protocol” can take up to 18 months to show a “negative” heartworm status for my dog. Depending on the severity of the heartworm infection, some may be sooner and some may be later – but that most heartworm positive dogs do test negative within 10 months to 14 months.

I understand that due to the physiological differences of the Great Pyrenees breed, to have a slower metabolism and higher negative physical reactions to the medications in the “fast kill” treatments, that the Great Pyrenees Rescue Society requires that all HW+ dogs adopted through this rescue must use the “slow-kill treatment” for their health and well-being.

I understand that if I decide to break this contract, and begin the fast-kill treatment plan on my adopted dog, that I am responsible for all medical issues and/or side effects that may arise from using the fast-kill medications.

I understand that if my adopted dog develops seizure disorders, neurological disorders, or dies from the fast-kill treatment plan, that I will not be reimbursed for my dog, and I will not be given a “replacement dog”, and I will not be allowed to adopt from the Great Pyrenees Rescue Society again.

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