International Health Certificate Information
Thank you for filling out this form and helping our staff prepare for your visit.
Your pet's name
*
Your Full Name
*
First Name
Last Name
Cell phone number where we can reach you during your appointment if needed
*
Format: (000) 000-0000.
Date of Your Scheduled Appointment
*
-
Month
-
Day
Year
Date
Health Certificate Information:
Name of responsible person HERE or the person traveling with the pet (this is the name that will be on the health certificate--typically the owner)
*
First Name
Last Name
Address where your pet has been residing HERE
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number HERE
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of responsible person AT THE DESTINATION (Typically the owner or person receiving the pet at the destination)
*
First Name
Last Name
Address AT THE DESTINATION, include street, city, state, postal code, and country as applicable. PLEASE INCLUDE THE COUNTY if within the United States:
*
Phone Number AT THE DESTINATION
*
Pet's Name
*
Pet's Breed
*
Pet's Age and/or Birthday
*
Pet's Color
*
Is your pet:
*
Female, intact
Female, spayed
Male, intact
Male, neutered
To which state or country is your pet traveling?
*
Type of Travel:
*
Permanent Import (if your pet is moving there permanently)
Re-entry (your pet is returning to a previous location)
Temporary Admission (your pet is visiting temporarily)
Transit (traveling through)
Other - please make a comment below
Date of Departure for Travel
*
-
Month
-
Day
Year
Date
Date of Arrival at final destination
*
-
Month
-
Day
Year
Date
Is your pet traveling:
*
By car
By air in cargo (under the plane)
By air in the cabin (with you)
Other
If flying, which airline?
Is your pet traveling with you/owner on the same plane? If not, please add details:
Do you have any layovers or stops prior to arriving at your final destination?
*
No
Yes, please detail below all the other airports, cities, states, and countries, and the length of time your pet will be at each
If you answered, "yes" that you have layovers, please detail other airports, cities, states, and countries, and the length of time your pet will be at each. If you are traveling out of the country, which US airport is your last stop before leaving the country.
Do you have an original signed rabies certificate and all other required documents in your possession?
*
Yes
No
Any other comments or questions?
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