I struggled with this rating because they did an excellent job saving my puppy's life. The medical care is excellent - I'm a nurse and can judge medical fairly well. My biggest concern is how they price gouge for everything they do. For example: I brought in my dogs pills and they wanted to charge me $20 each time they administered them. I would have paid more for them to give the pills than I paid for them. I understand they are a business and need to make money - but the prices are over the top. They charge $70 for a "transfer fee" to read the vet records from your vets office, then $90 for the doctor to do her own exam. My puppy was sick - they needed to give him an IV and blood products (he got into a blood thinner medication) and that's expensive. But they had multiple prices like $90/day to use an IV machine and $156 for a simple blood test they run in house are examples of what made me cringe. I ultimately felt grateful to them but sad that such a fine place practices like it's so much about money. I am only writing this honestly because I hope people voicing concerns might make some changes. I ultimately asked to speak with the MD and the "manager" about the pricing and was able to negotiate the bill down (they took off the fee for giving my dog the meds I came in with and transfer fee). I would definitely recommend doing this if you need to go here and talk with them about the pricing. But I am glad they are in the area and are providing great care. My puppy is doing really well.....