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R Book online ×

Simply answer these questions.
No referral is needed!

Choose Clinic

Select a region

Are you a new patient?

Appointment Type

Appointment Date & Time

Z Online Quick Code

If you know your quick code, enter it here to match your booking directly to your patient record.

Your Name

Please use your full name instead of a short name.

Contact Details

Date of Birth

Reason for your appointment

Please include any other relevant information

Do you have a referral?

None Medicare EPC/TCA WorkCover CTP Other

Click or tap on a previous answer to change it.
Please note, your appointment time cannot be guaranteed until you submit the form.

× c Find a clinic

Find your nearest Downs Physiotherapy clinic with your device's location or post code/suburb.

c See our full list of locations

If the results do not seem correct, you may need to add your city or state to the search. Your GPS location is never stored on our servers.

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Vestibular Pre-Booking Form

Please enable JavaScript in your browser to complete this form.

Name: *

DOB: *

Email *

Phone *

1. Do you feel like the room is spinning?

loss hearing which

2. How long does the spinning last?

Less than 2 minutes
More than 2 minutes

3. Spinning is aggravated by these activities:

Rolling in bed
Getting in to bed
Bending
Sitting still
Walking
All activities

4. Do you normally have hearing loss?

If yes which ear do you normally have hearing loss in?

Left
Right
Both

Have you had a hearing test before?

How long since your last hearing test?

5. Do you have new hearing loss when you have your spinning sensation?

If yes which ear do you notice your hearing loss in?

Left
Right
Both

6. Do you experience any other symptoms when you are dizzy?

Headache
Nausea / vomiting
Irritability to lights/glare
Irritability to noise
Loss of balance

7. Are you a Dr Allsopp patient waiting to have Cochlear Implant Surgery?

Date: *

Please choose the date today

Downs Physiotherapy also has a sister clinic, Peak Performance Sports Physiotherapy, operating out of Willows Health and Lifestyle Centre, Kitchener Street, Toowoomba.

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