Holter Request

Thank you for your interest in testing your dog for Inherited Ventricular Arrhythmias (IVA). This disease, which strikes without warning, has affected some Shiloh puppies and led to great heartbreak for their owners and their breeders. By testing your puppy, you will know if it’s necessary to provide the needed medication to improve their chance of surviving or if your puppy is free from this silent killer.

The ISSDC is proud to be able to assist our members in testing their pup. We offer the use of the Holter Monitor at a greatly reduced cost compared to having this test done by a veterinarian or cardiologist. The rental period is for seven (7) days after received. If you have multiple dogs to test, the rental period may be extended to accommodate your needs with prior arrangement.

Fees will be invoiced via PayPal and the holter will be shipped upon receipt of payment.
The following is an expected breakdown of the costs:

BASIC RENTAL FEE SCHEDULE  
Equipment Rental Fee (includes monitor, protective box, vest, vest pocket, velcro strap, card reader, two memory cards, clippers, a Supply Kit for one dog) $25.00 US
Additional Supply Kits (one per dog, includes batteries, electrodes) $10.00 US / each
Shipping Charges with Insurance (one-way shipping to you) $42.00 US
Additional Costs:  
Return shipping via US Postal Service Priority Mail (paid by you) $42.00 US
Reading of Test Results by Alba Medical (paid by you per analysis) $40.00 US / per test
Late Fee will be assessed for keeping the equipment beyond the agreed rental period $25.00 US / week / estimate
REPLACEMENT OF LOST OR DAMAGED EQUIPMENT FEE SCHEDULE
Should any of the equipment be lost or damaged while in your possession, you are responsible for the replacement value of anything that applies.
Holter Monitor (depending on availability) $1000 – $1500 US
Service for Monitor $100 – $500 US
Wires (depending on availability) $115 US
Vest $190 US
Velcro Strap for Vest $25 US
Card Reader $25 US
Memory Cards, each $25 US
Other unspecified repair(s) for damage is dependent on the cost
*The above prices are subject to change based on availability.		 varies

RENTAL TERMS
The rental period is 7 (seven) days upon receipt of equipment package.  

Breeder rental for multiple pups is 7 days (1 week) per puppy with prior arrangement. Breeder will be sent a sign up sheet to list each puppy receiving the holter in the rental period, owner’s name, contact information and the schedule for testing. 

Renter agrees to return the equipment (monitor & protective box, a clean vest & pocket, velcro strap, card reader, 2 memory cards, hook-up chart, data transmission guide, and clippers) to the ISSDC in the condition you received them at the end of your rental period. The package will need to be properly insured. Damaged equipment will be invoiced to renter.

Late Fee of $25.00 per week will be assessed for late return of the holter kit.

HOLTER TESTING REQUIREMENTS
Renter agrees to the following:

  • IF you wish to use vet wrap to secure the monitor, you will need to purchase some.
  • Check frequently for exposed wires which can be chewed and destroyed.
  • Holter test should be done when RENTER is home so that the dog can be supervised and damages avoided.
  • The dog should be allowed to perform all the activities of daily living including walks and play. Do not allow rough play that the monitor may become dislodged or damaged. Swimming or bathing should not be allowed as the monitor must be kept dry.
  • Submit results to ISSDC holter database at Holterproject@issdc.com

PAYMENT
All rental invoices need to be paid-in-full PRIOR to equipment shipping. Payment is to be made through PayPal to the International Shiloh Shepherd Dog Club (ISSDC). Upon submitting your Holter Request, you will be invoiced through PayPal. You will be contacted and the equipment will be shipped to you upon receipt of the completed contract and payment.

QUESTIONS?
Contact us at holterproject@issdc.com

ISSDC Holter Request Form

ISSDC Holter Request Form

RENTER INFORMATION

Name
Name
First
Last

HOLTER REQUEST

Type of Rental?
Equipment Rental
Equipment Rental Fee (includes monitor, protective box, vest, vest pocket, velcro strap, card reader, two memory cards, clippers, a Supply Kit for one dog)
Additional Supply Kits
Additional Supply Kits (one per dog, includes batteries, electrodes, wrap, and wipes)

RENTAL PLAN DETAILS

Rental Cycles with multiple stops are limited to a single breeding. Below please list the information for each holter user you intend to ship the holter to, placing them in order of who receives the equipment first down the line to who will receive it last before its return. In the event there are more than ten families that the equipment will be shipped to please print a second form and fill out accordingly. There is a one week period per dog allowed. In the event the holter is kept beyond the allotted period, penalties and fees may apply. Further more, inability to pay penalties and fees incurred will result in the revoking of holter rental privileges through the Holter Project initiative. Thank you for your cooperation and continued effort in these endeavors.

You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.
You MUST include ALL information: dog's name, sire/dam, date of birth, owner's name, owner's address.

AGREEMENT

I have read and agree to the following terms as detailed above ...
(check all that apply)
By submitting this form ...
I agree to the terms of this agreement and understand that I am responsible for any damage done to any of the equipment while it is in my possession. I also agree to return the equipment at the end of the rental period in the condition that it was received in.