Welcome to Vista Animal Hospital!

Your pet’s health and well-being is our first priority. Please help us in providing the best care possible by filling out this form completely and legibly. Thank you!

"*" indicates required fields

Name
Physical Address*
Mailing Address Different?
Mailing Address Different?
Mailing Address (if different)

Vista Animal Hospital primarily sends appointment confirmations via email and text message. Email addresses are used only for the purposes of patient care updates, appointment and vaccine reminders, special announcements, test results, and digital x-rays. They will never be shared with outside parties nor sold to vendors.

Text Messaging
Do you consent to Vista Animal Hospital sending you appointment confirmations via text message and email?
Email Address*
How Heard?*
How did you learn about our hospital? Check any that apply
Please tell us who we may thank.
Please let us know how you found us.
Add Another Pet Parent (Co-Owner)?*

Pet Parent #2 (Co-Owner)

Pet Parent #2 (Co-Owner) Name
Text Messaging
Do you consent to Vista Animal Hospital sending you appointment confirmations via text message and email?
Pet #1 Name
Pet's Name
Give pet's age if DOB unknown.
Sex of Pet*
Spayed/Neutered?*
Add another pet?

Pet #2 Information

Pet #2 Name
Give pet's age if DOB unknown.
Sex of Pet*
Spayed/Neutered?*
Add another pet?

Pet #3 Information

Pet #3 Name
Give pet's age if DOB unknown.
Sex of Pet*
Spayed/Neutered?*
Add another pet?

Pet #4 Information

Pet #4 Name
Give pet's age if DOB unknown.
Sex of Pet*
Spayed/Neutered?*

Consent for Treatment

I, the undersigned owner or owner’s agent, of the pet(s) identified on the pet information sheet(s), acknowledge and confirm the information here and on additional pages, is accurate and correct to the best of my understanding.
I, the undersigned owner or owner’s agent, of the pet(s) identified on the pet information sheet(s), acknowledge and confirm the information here and on additional pages, is accurate and correct to the best of my understanding.
I, the undersigned owner or owner’s agent, of the pet(s) identified on the pet information sheet(s), certify that I am over eighteen (18) years of age and thereby consent to the examination of my pet by the veterinarians and staff of Vista Animal Hospital LLC, and, after consultation with me, to prescribe medications for, treat, hospitalize, anesthetize, and/or perform surgery on my pet. I understand that some risks always exist with the medical treatment of my pet, including anesthesia and surgery and that I am encouraged to discuss in detail my concerns with my attending veterinarian to understand the risks before treatment is initiated. Should unexpected life-saving emergency care be required and my attending veterinarian is unable to reach me, Vista Animal Hospital LLC has my permission to provide such treatment and I agree to pay for such care. I understand that 24-hour continuous supervision of my pet is not provided if my pet is to be hospitalized and that I can elect to have my pet transferred to a 24-hour facility if indicated.
I, the undersigned owner or owner’s agent, of the pet(s) identified on the pet information sheet(s), certify that I am over eighteen (18) years of age and thereby consent to the examination of my pet by the veterinarians and staff of Vista Animal Hospital LLC, and, after consultation with me, to prescribe medications for, treat, hospitalize, anesthetize, and/or perform surgery on my pet. I understand that some risks always exist with the medical treatment of my pet, including anesthesia and surgery and that I am encouraged to discuss in detail my concerns with my attending veterinarian to understand the risks before treatment is initiated. Should unexpected life-saving emergency care be required and my attending veterinarian is unable to reach me, Vista Animal Hospital LLC has my permission to provide such treatment and I agree to pay for such care. I understand that 24-hour continuous supervision of my pet is not provided if my pet is to be hospitalized and that I can elect to have my pet transferred to a 24-hour facility if indicated.

All professional fees are due at time the services are rendered except as previously described – we accept cash, checks, Debit cards, VISA, MasterCard, Discover, American Express, and Care Credit. There will be a $25 fee for any check returned unpaid.

Any animal left without owner involvement (5 days written notice via certified mail) is subject to abandonment rights and shelter authorities, with all charges still pending and the owner remaining responsible for all charges plus interest. Customer agrees to pay a finance charge of one and one-half percent (1.5%) per month on all amounts due and owing to Vista Animal Hospital LLC.
Photographs & Video – With my signature below, I allow Vista Animal Hospital LLC to use photographs or videos of my pet for educational or promotional purposes in any type of media, including its website and Facebook. I understand that I will not be paid or rewarded for providing this authorization. Should Vista Animal Hospital LLC wish to identify my pet or myself by name, they will seek my express and written consent for this use.
Electronic Signature Acknowledgment*