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 Neutered Male
 Intact Male
 Spayed Female
 Intact Female


I hereby authorize the veterinarian to examine the above described animal. I assume responsibility for all charges incurred in the care of this animal. I understand that a deposit will be required before all procedures and hospitalized animals. I also understand that charges are to be paid in full upon completion of services. Should it be necessary to settle my account through a collection agency or attorney, I agree to pay any and all interest, collection costs, and legal fees.

We apologize, but we do not accept checks. Our acceptable forms of payment are Visa, Master Card, Discover, Amex, Care Credit, Cash and Debit.


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AAHA Accredited ReferralNYSED Approved for Veterinary Continuing Education
VMCLI
75 Sunrise Hwy
West Islip, NY 11795-2033

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Phone: 631.587.0800
Fax: 631.587.2006

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