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188 East Main St.
Huntington, NY 11743
Tel: (631) 517-1773
Fax: (631) 517-1753
Emergency &
Critical Care
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Menu
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Menu
About Us
Who is VSCLI?
Mission & Core Values
Why Choose VSCLI ?
What is a Veterinary Specialist
About the VSCLI Patient Experience
Our New Hospital (Virtual Tour-photos)
Our Team
Meet our Team
Meet our Founders
Meet our Surgeons
Meet our Emergency Veterinarians
Meet our Support Staff
Practice Manager
Photo of the Team
Services
Orthopedic Surgery
Soft Tissue Surgery
Surgical Neurology
Surgical Oncology
Emergency Care
State Of The Art Diagnostics
Overnight Care
Cold Laser Therapy
In-House Laboratory
End of Life / Euthanasia / Cremation
For Pet Owners
Making an Appointment
Emergency Patients – What to Expect
Surgery Patients – What to Expect – for Consultation
Surgery Patients – What to Expect – on Surgery Day
Pre-Register BEFORE my First Visit (to speed up check in process)
Recognizing a Medical Emergency
Payment Options
Access VSCLI’s Medical Library
For Veterinarians
Our Partnership & Commitment to the Primary Care Veterinarian
Veterinarian Service Request Referral Form
Register as a Referring Veterinarian
Continuing Education at VSCLI
Hospital Tour
Virtual Tour
Videos
Blog
Emergency Care
Pet Surgery
Contact & Location
Contact Us
Making an appointment
Having an Emergency
Forms for Pet Owners
New Client Registration Form
Intake Form – Surgery
Intake Form – Emergency
Forms for Referring Veterinarians
Veterinarian Service Rqst Referral Form
Providing Feedback about my Visit?
Areas Served
Commack, NY
Northport, NY
Plainview, NY
West Islip, NY
Woodbury, NY
Veterinarian Service Request Referral Form
You can fill out the form here or download the online form by
clicking Here
Referring Clinic Information
Referring Veterinarian First and Last Name
(Required)
Name of Referring Clinic/Practice Name
(Required)
Clinic/Practice Street Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Clinic/Practice Phone
(Required)
Alternate Phone #:
(Required)
Fax Number
(Required)
Email
(Required)
Communication Preference:
Phone
Fax
Email
Client and Patient Information
Name
(Required)
First
Last
M.I.
(Required)
Add’l Owner(s)
(Required)
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Home Phone
(Required)
Cell Phone
(Required)
Work Phone
(Required)
Client Email
(Required)
Other Information
Patient Information
Pet’s Name
(Required)
Species
(Required)
Canine
Feline
Other (specify)
Sex
(Required)
Male
Female
Male Neutered
Female Spayed
Breed
(Required)
Patient Date of Birth or Age
(Required)
Pet’s Color
(Required)
Patient Weight (indicate lb vs kg)
(Required)
Patient Temperament
(Required)
Veterinarian Service Request
Service Request
(Required)
Surgical Consultation
Emergency Service
Services Requested:
(Required)
Presenting Problem:
(Required)
Medical History:
(Required)
Pertinent Laboratory Results:
(Required)
Pertinent Diagnostic Imaging Results (Radiographs, Ultrasound, MRI, CT):
(Required)
Treatments Performed, Medication with Dosages, Last Time Given:
(Required)
Current Medications:
(Required)
Close Menu
About Us
Who is VSCLI?
Mission & Core Values
Why Choose VSCLI ?
What is a Veterinary Specialist
About the VSCLI Patient Experience
Our New Hospital (Virtual Tour-photos)
Our Team
Meet our Team
Meet our Founders
Meet our Surgeons
Meet our Emergency Veterinarians
Meet our Support Staff
Practice Manager
Photo of the Team
Services
Orthopedic Surgery
Soft Tissue Surgery
Surgical Neurology
Surgical Oncology
Emergency Care
State Of The Art Diagnostics
Overnight Care
Cold Laser Therapy
In-House Laboratory
End of Life / Euthanasia / Cremation
For Pet Owners
Making an Appointment
Emergency Patients – What to Expect
Surgery Patients – What to Expect – for Consultation
Surgery Patients – What to Expect – on Surgery Day
Pre-Register BEFORE my First Visit (to speed up check in process)
Recognizing a Medical Emergency
Payment Options
Access VSCLI’s Medical Library
For Veterinarians
Our Partnership & Commitment to the Primary Care Veterinarian
Veterinarian Service Request Referral Form
Register as a Referring Veterinarian
Continuing Education at VSCLI
Hospital Tour
Virtual Tour
Videos
Blog
Emergency Care
Pet Surgery
Contact & Location
Contact Us
Making an appointment
Having an Emergency
Forms for Pet Owners
New Client Registration Form
Intake Form – Surgery
Intake Form – Emergency
Forms for Referring Veterinarians
Veterinarian Service Rqst Referral Form
Providing Feedback about my Visit?
Areas Served
Commack, NY
Northport, NY
Plainview, NY
West Islip, NY
Woodbury, NY
188 East Main St.
Huntington, NY 11743
Tel: (631) 517-1773
Fax: (631) 517-1753
Emergency &
Critical Care
