First I must say that this hospital took great care of my two cats when I had to put them down. My puppy and me... Not so much. I took my new (and first) puppy there for her first visit and shots. The doctor never mentioned to me to be sure that my puppy stayed calm and didn't play much after her shots. Several hours after receiving her vaccines she threw up. They told me to bring her in immediately and proceeded to give her medications adding up to a couple hundred dollars. At her next visit I mentioned that I only wanted to give her one vaccine. The receptionist and the vet on staff proceeded to basically tell me how stupid it was to do that. All I really wanted was a little more information and time to think over my options. When ID cited to have her vaccinated and neutered I went to another hospital where the staff was very patient and educated me with out giving me any of their own personal opinions. I'm done with Sienna.