Book an appointment
Fill in this form and one of our team will contact you within business hours (8.30 am to 4.30 pm), on the contact details you have provided to confirm a day and time slot.
Alternatively, you can check the upcoming Wide Bay clinic dates and phone to make an appointment.
Online form
Let us know where you'd like to see and what date or time suits you best. We'll contact you by text, phone or email, between 8:30 am and 4:30 pm to confirm your appointment date and time with you. The call will come from a private or unknown number.
Information disclaimer and consent
While Queensland Health endeavours to ensure that the online transmission of the form, containing your information, over the internet is secure, the inherent nature of the internet means that there is a potential risk that your information may be viewed or intercepted by third parties. Accordingly, submission through the online form shall be at your own risk and Queensland Health accepts no responsibility or liability for any unauthorised access to your information contained in the form when it is submitted online over the internet. It is inadvisable to complete this form on a public or shared computer. If a public or shared computer is used then this shall be at your own risk, and you must take all reasonable steps to ensure your confidential information does not remain on the computer or in any way accessible by a third party. Individuals who submit the form online should receive an acknowledgement from Queensland Health that the form has been sent, on the screen, following submission. Queensland Health accepts no responsibility or liability if this acknowledgement does not appear or we do not receive your online submission. You acknowledge that you have read and understood Queensland Health's Privacy Statement and Disclaimer.
