Request an Appointment (Ipswich only)

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
Title
First Name*
Surname*
Phone Number*
Email Address*
Address*
Street Address Address Line 2 City Post Code
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*
Date Format: DD slash MM slash YYYY
First prederence 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*
Date Format: 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 only)

Address: 42 Tiger Street, West Ipswich QLD 4305

Contact Details

Your Pet's Information

Appointment Details

AWLQ recognises the valuable contributions of the following organisations and supporters

PHONE SCAM ALERT