Vienna Road Veterinary Surgery
Modern Medicine - Old Fashioned Care 

Vienna Road Veterinary Surgery
8/195 Vienna Road
Alexandra Hills Q 4161
(07) 3824 7788

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Drop-off appointments are available for your convenience. Please fill in the form completely. By pressing the "Submit" button, you are authorising veterinary costs, including examination, diagnostics and treatment, up to the limit selected on the form. Please be aware that authorised treatment amounts will need to be paid on admission, and any overpayment will be refunded at the time of patient discharge.

Form - Drop Off Appointment Form

Owner's Name (required)
First Name (required)
Last Name (required)
Contact number for day of appointment (required)
Phone TypePhone Number (required)
Home Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
E-Mail Address (required) :
Patient Details
Patient's Name (required)

Species (e.g. Dog or Cat ) (required)

Breed (e.g Domestic Shorthair or Staffordshire Bull Terrier) (required)

Reason for appointment: (required) :
Please describe your Pet's symptoms if unwell or injured.

Please select the date and time you wish to drop your pet to the surgery:
Please advise the date you require a drop-off appointment: (required)

08:00 am
10:00 am
14:00 pm
Please select the time you wish to collect your pet from the surgery:
14:45 pm
16:45 pm
Please indicate the maximum treatment cost authorised without further discussion.
N/A - My pet is booked in for wellness care (e.g. Vaccination).
$100 (Examination costs only) - please call me before providing any treatment.
$250 - please call me if treatment costs are likely to exceed this amount.
$500 - please call me if treatment costs are likely to exceed this amount.
If this is your pet's first visit to VRVS, please also complete & submit the New Client/Patient Form

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