Admittance Form

Admittance Form

Credit Card Authorization Form

Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.
Credit Card *
Credit Card
Credit card Number
Card expire month
Card expire year
Cardholder ZIP code (from credit card billing address)
By click on below checkbox I, authorize Pet Doctor Clinic to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.
09/28/2021
Accept Terms *

2562 Francis Lewis Boulevard
Flushing, New York 11358
Directions
(718) 886-6661
petdoctor01@gmail.com