Tanasbourne Veterinary Emergency is a privately-owned referral hospital located seven miles west of Portland, Oregon in Beaverton. The owner of this thriving practice asked rfa to design a new 30,000 SF facility on a steeply-sloped, narrow, triangular building lot. In this case, the shape of the lot and required building setbacks necessitated locating the mass of the building close to the road at the bottom of the slope with insufficient space above and behind the building for parking. Part of the solution was to excavate a portion of the slope and insert a parking level and utility spaces below the building. This also created enough space above to locate all clinical functions on one level with grade access to the rear parking lot, but it would also necessitate a rear main entrance. Having resolved the major site challenges, the balance of the solution was to create an appealing street presence, even though the "front" of the building faced the back of the lot. Street appeal was created by using contrasting materials to define distinctive practice areas, such as the large central treatment window bays and book-ending stair towers. This concept translated well to the rear entrance façade with the incorporation of a cluster of clerestory shed roofs above the waiting areas. Architectural supergraphics signage elements were also designed to draw attention to the street-front façade. A smaller second floor accommodates all staff, support, and administrative spaces, including a generous landscaped green roof garden. The state-of-the-art hospital includes eleven exam rooms, a six-table treatment area, three surgery rooms, cardiology, specialty procedures, CT scan, and all support functions needed for this size and type of hospital. A dramatic high-bay waiting area incorporates several special design features, including local historic photos, a glazed staff cat play loft, and a unique primary doctor's route to the waiting area.