Criteria for use:
* Animal Owner must provide his own protective inflatable collar or cone collar.
* Treatment Installation Instructions provided to participants upon confirmation of order form and waiver. *
Process to Order:
1. Copy the Participant Order Form below.
2. Click on Email address at top of page, and paste the copied order form into new email. Scroll down into this new email and type in your answers.
3. Type in your names in the Samaritan waiver to accept participation.
4. Attach pictures of both ears of animal for reference and inclusion in your case file and send email.
5. Auralsplint will return a confirmation notice along with the Instruction tutorial and any questions needed to fulfill your Auralsplint Treatment Kit order.
6. Go to PayPal button below, click and submit payment $75.00.
I will return to you confirmation of receipt of order, and any questions I may have to complete your order. A complete set of Treatment Instructions (PDF) will accompany my reply. Only the name of animal and case number will be used in all reporting. All personal information is kept private and will not be shared. The survey form (included in kit) provided is to be filled out after the treatment and returned to Auralsplint@yahoo.com for inclusion in your case file and in the subsequent studies.
Please take a picture after application of the plates and send this to Auralsplint for verification and inclusion in your case file.
The Auralsplint™ treatment is only for sale here at this time and included with participation in the study. We charge for the postage to ship the treatment next day USPS where available to you, and the costs of materials and handling. Treatment kit includes proprietary Auralsplint plates, 2 rolls medical tape, bandage scissors, alcohol wipes, hypodermic needle, instructions and survey form to be returned after the 14 day treatment.
Shipping and materials are paid through PayPal. Account holders and credit/debit card accepted.
Total costs include next day USPS in the USA $75.00 USD, next day UPS Expedited to Canada $145.00 USD, 1-2 day delivery. FedEx option for Canadian orders additional $50. All orders will be confirmed before processing and shipping. Next day USPS and UPS are determined by location. Could be second day for those off the beaten path. 2-Day shipping will be notified by email with copy of shipping receipt to track.
*Copy and paste order form below into new email with address above. Enter cursor into new email and answer questions, type sign waiver, press send. Auralsplint will contact you as soon as email is received and processed.
* Auralsplint™ 2023 Participant Order Form *
Has the animal had an aural hematoma before and what ear?
How long has this hematoma been present (days and weeks)?
How many aspirations have taken place before treatment aspiration? Specify needle or other.
Has the animal been on any medications, what kind and what dosage?
Has the animal been treated before with surgery?
Has the animal been treated before with holistic medicines or therapies?
Vet diagnosis about possible infestation or infection:
Measurements and specifics of the ear:
Height of ear from head:
Width around back of ear curve (see diagram):
Type of ear pendent or erect:
Type of animal breed:
Animal’s left ear or right ear:
Owner Name and Shipping Address and Phone Numbers:
Case Study Number: AHS
Auralsplint™ Samaritan Waiver
I, (type sign name here ) , do hereby release Auralsplint Inc. PBC and its owners and affiliates of any liability due to the misuse, misapplication, or any wrongful behavior resulting in any damages occurring during treatment. Auralsplint™ retains rights to product and procedure, and its services are not to be duplicated by any means except for the expressed use of animal intended at time of participation. Auralsplint™ independently provides this Rx only treatment as an alternative to surgery for early onset aural hematoma to signed participant or licensed veterinarian. As with any medical treatment, the results are not guaranteed. I have read, understand, and agree with the Participant Acceptance information on Measure the Ear page.
For Office Use:
End of Order Form
All orders are subject to authorization and waivers signed in order form.
Use the Case File Number given to you at time of acceptance as comment.