Request an appointment – Ipswich

Address: 42 Tiger Street, West Ipswich, QLD 4305

PLEASE NOTE!
When making an appointment online, please allow between 5-7 days when choosing a date. If you are booking an appointment for an emergency situation, please call the Ipswich Community Vet Clinic Direct on 07 3812 7533

This form is to request an appointment for veterinary services only if you are looking for the pet surrender form, please look under the Pet Help section

All fields marked * are required.

Contact Details
First Name*
Surname*
Phone Number*
Alternate Phone Number (optional)
Email Address*
Address*
Street Address Address Line 2 City Postcode
New Client?
- Yes
- No
Your Pet's Information
Pet's Name*
Breed*
Age/D.O.B.*
Sex*
- Male
- Female
Microchip No
Colour
Desexed*
- Yes
- No
Did you adopt your pet from the AWLQ?
- Yes
- No
If yes, when did you adopt your pet?
Appointment Details
Current Heartworm Prevention?
Current Flea & Tick Control?
Current Intestinal Worm Prevention?
Reason for visit*
First preference appointment date*
DD slash MM slash YYYY
First preference appointment time*
If we are unable to accommodate your appointment request, please select a second preference for your appointment time and date below.
Second preference appointment date*
DD slash MM slash YYYY
Second preference appointment time*
Comments
This field is for validation purposes and should be left unchanged.

Request an appointment – Ipswich

Address: 42 Tiger Street, West Ipswich, QLD 4305

Contact Details

Your Pet's Information

Appointment Details