Is there anyone else you would like to add to the account that could have access to your pets healthcare information (family member, pet sitter, etc)?

Additional Information

Treatment Consent

I, the owner of the patient(s), hereby authorize the veterinarians and staff of Mountain View Animal Hospital & Holistic Pet Care to examine, treat, and prescribe necessary medication for the above listed pet. This includes, but is not limited to, procedures therapeutically and/or diagnostically. I understand that no guarantee of successful treatment is made. I further understand that this facility has a doctor on staff between 7:30am to 5:30pm only, therefore, there is no continuous presence of doctors after regular business hours. I certify that all the information above is correct, that I am the rightful owner or authorized agent of this pet(s) and that I am at least 18 years of age. Mountain View Animal Hospital & Holistic Pet Care does not operate as an emergency hospital and although we will always try to be available, I understand I may be referred to an emergency hospital even during open hours if we feel it is best for my pet(s).

I understand by Nevada pharmaceutical law, all prescriptions including herbals that leave the hospital are non-refundable, even if my pet(s) has a reaction.

Payment Policy

Please note: All fees incurred at Mountain View Animal Hospital & Holistic Pet Care are required to be paid upon time of service. We do not accept payment plans or delayed billing. Any unpaid balance left unpaid are subject to accrued 1.5% interest after 30 days, and balances left unpaid for more than 90 days will be sent to collections in addition to a 40% collection fee. There is a $35 charge for each returned check, and we do not accept any postdated checks.

We accept Visa, Mastercard, American Express, CareCredit & for established clients (been here at least 2 times) we also accept checks.

Cancellation Policy

We request that any cancellations be made at least 24 hours prior to the start of your pet's medical appointment, grooming appointment or boarding/daycare reservation. If you cancel without ample notice or do not show up to your appointment or boarding/daycare reservation you may be required to pay a cancellation fee. This fee is non-refundable and cannot be applied toward any other services.

I have read, understand and accept all the information above.

Electronic Communication Disclaimer

Mountain View Animal Hospital & Holistic Pet Care offers client communication through both calls and texts. If you choose to text our office, you are entering into the agreement detailed below.

By enrolling in our texting program, you are authorizing our office; Mountain View Animal Hospital & Holistic Pet Care, to send text messages to you on your provided cell phone number. You certify you are the person who is legally responsible for all use of the accounts, and are at least 18 years of age or older, and have agreed to all terms and conditions of use for the text messaging services. You understand that you can reply to confirm appointments, make future appointments, and get office location, office hours, and other alerts /information. Text message charges from your cell phone carrier may apply.

Mountain View Animal Hospital & Holistic Pet Care offers a text messaging system to our current clients for the following:

Appointment confirmations, and other services and content deemed appropriate. By opting-in our text messaging program, you are providing consent for us to reach you via text for confirmation, cancelations, rescheduling, office closing, follow-ups and any other forms of communication. Data and message rates may apply so please contact your cell phone carrier for additional information regarding your text messaging plan/coverage.

^**We respect your privacy and will never share your information without your consent. We use email as a form of primary communication to relay important information or changes about our hospital, education and share our upcoming promotions. In addition, you may receive your pets healthcare reminders and have the ability to confirm upcoming scheduled appointments.^**

Mountain View Animal Hospital and Holistic Pet Care

6474 Bonde Lane Reno, NV 89511

775-853-6900 (phone); 775-853-6966 (fax)

Pet's Information

Media Consent

At Mountain View Animal Hospital and Holistic Pet Care, we LOVE to share our patient's cute faces! We try to photograph their success stories, "spa days", playtime in boarding or daycare, and really any moment we can capture that expresses that love! In addition, we add your pet's picture to their medical profile for safety and identification purposes. With this, we require authorization.

I hereby grant Mountain View Animal Hospital and Holistic Pet Care permission to use any photographs taken of my pet in all its publications, including website and social media entries. I understand this is voluntary and I am aware I will receive no compensation. I understand and agree that these materials will become property of the hospital. I hereby release the hospital and its employees from any claims, demands, and causes to action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or the behalf of my estate, have or may have by reason of this authorization.

Release of Liability for Holding

Our staff is trained to physically manage, hold, or otherwise restrain your pet in the safest and most comfortable way. Should you decide that you wish to assist during exams or procedures, our staff and hospital shall not be held liable for any injury that may arise, whether it be done to or by your pet.

I have read and understand the release of liability for holding my pet and the media consent form and have been given opportunity to ask any questions.

Mountain View Animal Hospital and Holistic Pet Care

6474 Bonde Lane Reno, NV 89511

775-853-6900 (phone); 775-853-6966 (fax)

Ultrasound & Sedation Consent

Thank you for entrusting Mountain View Animal Hospital and Holistic Pet Care to perform a diagnostic ultrasound. Ultrasonography is a non-invasive technique to image organs within the abdomen or chest. The area to be imaged must be shaved in order to provide adequate imaging, and minor irritation may occur to the skin as a consequence. Hair regrowth generally takes multiple weeks to occur, but can be more prolonged in certain pets.

The ultrasound is performed by a third party certified ultrasound technician. A nurse or assistant will phone when the testing is complete and will discharge your pet. The technician can not legally provide any medical findings. Further, the results typically are not available on the same day as the ultrasound. The images are sent to a board certified ultrasound radiologist and/or cardiologist for review. Your primary veterinarian will be contacting you with results and treatment plan once the results from the radiologist are completed. The results take 2-4 business days unless they were sent STAT for an additional charge because of an emergency situation. The ultrasonographer technician is not available for consultation with clients.

If indicated, fine needle aspiration is a procedure involving placement of a needle, using the guidance of an ultrasound, into an organ or mass. A sample of tissue cells is drawn into the needle, placed on a slide, and sent in to a diagnostic laboratory to look for cancer cells, inflammation or other abnormalities. This procedure is often recommended if an abnormality is identified on ultrasound, and is the first step towards diagnosing the nature of the abnormality. Some problems are easily diagnosed via fine needle aspiration but others may not yield an answer via this technique. Fine needle aspiration is generally a safe procedure, but there is a small risk of significant bleeding from the organ or mass targeted. The risk is increased in patients that have a bleeding disorder and in certain cancerous masses, but may also rarely occur in patients that were not considered to be at risk, and may require intervention to stop or risk serious health complications. Fine needle aspirations would be performed by the attending doctor. Possible blood work to assess bleeding concerns is always recommended and can be performed the same day, prior to any aspirations at an additional cost.

Light sedation is typically necessary to perform the ultrasound, fine needle aspirations, and other diagnostic tests to receive accurate results and the clearest images, as even light panting can cause distorted images that may result in misinterpretation. Sedation usually only last a few hours, but some patients that are more sensitive can remain quiet until the following day. Rarely, depending on the type of sedation used, there may be a detrimental impact on blood pressure, heart rate, or breathing that could require intervention or risk serious health consequences. General anesthesia is usually never necessary.   

Please initial if giving consent:

I consent to have an ultrasound performed on my pet by the certified ultrasound technician.

I have signed/will sign the sedation consent form prior to my pet being admitted to the hospital.

I consent to have fine needle aspirations performed on my pet if deemed indicated by results of the ultrasound and accept additional costs. If aspiration is performed, a coagulation blood test (PT/PTT) will be performed prior at an additional cost. (if initially declined, a repeat visit *with a possible recheck ultrasound fee* can be scheduled)

Authorization for Sedation

I have elected conscious sedation for your pet's procedure today. This sedation will be "light conscious sedation" where my pet will maintain protective reflexes, however, they will be less aware of their environment. I certify that I am the owner, or authorized agent of the owner, of the animal above and have full authority to execute this agreement. I also certify that I am 18 years of age or older. I authorize Mountain View Animal Hospital and Holistic Pet Care (MVAH & HPC), its veterinarians and employees under veterinary supervision, to perform the procedure(s) identified above. I understand that some risk always exists with sedative administration and invasive procedures and that during performance of these/this procedure(s), conditions may be encountered that necessitate an extension of, or variance from, the procedure(s) set forth above. I have discussed the recommended procedure(s), associated risks and anticipated recovery with an attending veterinarian. All questions and concerns I have about sedation, procedures and associated risks have been answered to my satisfaction. I understand that a reasonable attempt will be made to contact me if expected fees will exceed the estimate by 15% or more. I agree to assume financial responsibility for all fees associated with the care of my pet and agree to provide payment in full, in accordance with the payment policy, at the time my pet is discharged. This consent will cover the next 12 months for any elective sedation procedures. I will notify the doctor if there are any changes in my pets health since the last sedation procedure.

CPR CONSENT AND RELEASE OF LEGAL LIABILITY

Based on the medical judgement of MVAH & HPC's veterinarian(s), should my pet require CPR, including cardiac compression, positive pressure respiration, emergency drugs, or other interventions, I request or decline that the doctor(s) at MVAH & HPC pursue such medical care as indicated below. Furthermore, I have been informed by the team at MVAH & HPC that less than 5% of animals that require CPR will survive to be discharged from the hospital. I understand that despite the best efforts of the veterinarians and the team members at MVAH & HPC, CPR may not allow my pet to regain his/her normal mental or physical capacity. Priced from $75-$150, charges are due in full upon pick up if CPR is performed. Regardless of whether I consent or decline to have CPR performed on my pet, in consideration for following my directive, I hereby waive, release and discharge any and all claims for damages, including, but not limited to, claims for death, injury or property damage, whether or not resulting from the negligence, gross negligence or other acts of MVAH & HPC, its veterinarians and staff. I declare that any such veterinarian, staff, and MVAH & HPC is acting in accordance with my directions. This is intended to be an advance release of legal liability.

I, the authorized owner, have read and understand everything stated above. I understand the results, unless an emergency and sent to the radiologist with an additional STAT fee, the results may take 2-4 business days to return. The attending doctor will call my primary phone number on file when received. I understand payment is required in full at time of discharge.

Mountain View Animal Hospital and Holistic Pet Care

6474 Bonde Lane Reno, NV 89511

775-853-6900 (phone); 775-853-6966 (fax)

Holistic Chinese Diagnostic History Form

Welcome to our Holistic Clinic! Please take several minutes to fill out this form. This detailed history helps our holistic doctors establish a Holistic medical diagnosis, aiding in our treatment and herbal recommendations. We encourage you to fill this form out anytime you feel there are major changes in your pets history. You may ask for this form at any of your recheck examinations.

Please Check off All that Apply:

Please check any Chronic Problems your pet has / is suffering from:

Five Element Quiz

The 5 elements are an old philosophy used to describe interactions and relationships between personality, health, and predispositions to common ailments. Once a holistic veterinarian has reviewed your pet and this quiz, they will supply you with the information of your pet's element.