(540) 377-5700

Our Steeles Tavern, VA Office

Mountain View Equine Hospital

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New Patient Information

Owner's Name
Address
Sex
Does Horse have any Dangerous Propensities?

Medical History of Horse

Does your horse have a history of Colic?
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Does your horse have a history of Founder?
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Current Immunization Record:

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Feeding Program

Grain
Type
Amount
Hay
Type
Amount

PERSON TO BE CONTACTED IN CASE OF EMERGENCY, IF OWNER IS CANNOT BE REACHED:

Name

Initial Below

MOUNTAIN VIEW EQUINE HOSPITAL, LLC SHALL ASSUME THAT OWNER DESIRES SURGICAL CARE IF RECOMMENDED BY A VETERINARIAN IN THE EVENT OF COLIC, OR OTHER LIFE THREATENING ILLNESS IF THE ABOVE “IS CONSIDERED SURGICAL CANDIDATE” IS INITIALED.

OWNERS AGENT AUTHORIZATION RELEASE:

“Owner” hereby authorizes the following person(s) to make decisions in the Owner's place with regard to the health (including but not limited to vaccinations, farrier, dental care, and lameness), well-being, and/or medical treatment of the horse.
Authorized Agent Name
Address
Mountain View Equine Hospital, LLC. will not be held liable in any way for any decision regarding health of horse made by Authorized Agent. If the above Agent is no longer acting as Agent for “Owner” it is the “Owners” responsibility to notify Mountain View Equine Hospital, LLC. in writing.
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Saving Lives, One Animal At A Time

Find Us Here

Address 309 Old B&O Rd
Steeles Tavern, VA 24476
Hours

Monday – Friday: 8:00 am – 5:00 pm

Emergency Hours
We are available 24/7 for in hospital and on farm emergencies

Contact (540) 377-5700

Get In Touch

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Contact Us

Mountain View Equine Hospital

(540) 377-5700

309 Old B&O Rd
Steeles Tavern, VA 24476

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