Urgent Care Appointment & Client Consent Form

Please note if you cannot be reached within a reasonable time frame, unless life-saving, no procedures will be performed on your pet until your approval. If sedation is necessary and it is after 3pm, the procedure will need to be scheduled for the next business day. You may expect a phone call typically within two hours of drop off on the number you listed above.

Current Nutrition - (At Mountain View Animal Hospital and Holistic Pet Care we believe in WHOLE BODY health which includes nutrition. We recommend evaluating your diet annually in a healthy pet with “Diet at a Glance” with Lori or more often if suffering from an acute or chronic illness “consultation” with Lori. She may discuss integrative nutrition and work with our doctors to create a balanced nutritional diet, treats and supplements.)

My pet has had: if there is a change, please note when it started and any other details

Client Consent

I authorize the veterinarian to examine, prescribe, and/or treat the above described pet. I assume full responsibility for all charges incurred for the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I understand that doctors are on site between 7:30am and 5:30pm. Although our boarding and daycare staff are on site for additional hours, they are not medically trained to monitor hospitalized patients. If your pet requires continual monitoring by a trained medical professional after release, transfer to one of the two overnight Emergency Centers in Reno is always our highest and best recommendation. 

I understand for the respect of religious and medical beliefs along with the safety of my pet, Mountain View and Holistic Pet Care, requires to have on file your request in regards cardiac and respiratory resuscitation in the case of a life saving measure. 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 save my pet’s life. I also understand that even successful, life restoring 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 in advance release of legal liability.

Sedation Consent (if applicable)

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. 

(Understanding declining sedation may limit or eliminate possibility of examination, diagnostics or treatments necessary to improve the outcome of your pets health. If truly necessary, a doctor may call you to discuss the risks/benefits and a change in the consent may be made over the phone with two witnesses.)

My signature below states I have reviewed all the information and I allow Mountain View Animal Hospital and Holistic Pet Care to perform examination, diagnostics and/or treatments on my pet. I have received a basic estimate, understanding based on the doctors examination, the charges may change and every effort will be made to go over changes in the estimate. I understand no additional diagnostics or treatments will be performed until I am reached. If I do not answer in a timely manner, unless life-saving, my pets treatment may be delayed until another day.