• WICA New Patient Registration Form

  • *IF YOU HAVE VISITED THE WALK IN CLINIC FOR ANIMALS BEFORE, PLEASE LET OUR STAFF KNOW*

  • Today's date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Current Time
  • (If still en route, please advise of your ETA)

  • Pet Owner Details

  • Preferred communication method for follow-ups*
  • Format: 0000-000-000.
  • Format: 0000-000-000.

  • Your Pet's Details

  • Is this pet desexed?*

  • Your Pet's Medical History

  • Informed Consent for Consultation  
      
    This notice is to advise you, our client, that the Walk In Clinic for Animals is an urgent care veterinary clinic. Our clinic does not provide advanced emergency surgeries and interventions such as ventilation, and we will refer you to an alternate emergency service provider if your pet requires this care.

    As we are an urgent care clinic, we do not see patients in a regular capacity nor for chronic disease management, and for these services we will refer you to a general practice veterinary clinic. By proceeding with consultation, you accept the risk that we may not be able to resolve all of your pet's medical issues tonight and may need to refer you on to another service. 

    We recommend that all clients choose a general practice veterinary provider and maintain a relationship with them for the long-term health and wellbeing of their pet. In proceeding with consultation, you acknowledge this recommendation. 

    Our standard consultation fee is $260. Medication, procedures, pathology, and specialised examinations will be in addition to this fee. 

    The Walk In Clinic For Animals accepts payment via EFTPOS, Amex, Direct Deposit, Cash, Vet Pay, Afterpay and GapOnly.

    Please be advised that veterinarians at the Walk In Clinic For Animals use AI notetaking applications that transcribe consultations into medical notes. All records are stored in Australia according to Australian data privacy principles. If you do not want your veterinarian to use this software, please advise them at the start of your consultation.

    In proceeding with consultation services here at the Walk In Clinic For Animals, you agree to pay your invoice in full at the end of your consultation. If you need to discuss payment services such as VetPay, please alert the front desk staff before starting your consultation.

  • Having read the above advice:*
  • I wish to receive a copy of this advice via email*
  • Authority to Release for patient photographs to be used for social media and for inclusion to clinical notes to be forwarded to your regular vet, relevant allied health and/or referral facilities*
  • Should be Empty: