Pet International Health Certificate Questionnaire
Where are you and your pet going (Destination Country or Countries)?
Does your pet have a passport:
Yes
No
What is your Current Address
Who will be traveling with the pet?
The Owner
No one (in Cargo)
Pet Transport Company
Other
Name of person traveling with pet as stated on passport
Please list the FULL ADDRESS of the destination country you will be traveling to
Telephone
Format: (000) 000-0000.
International Telephone: (if any)
-
Country Code
-
Area Code
Phone Number
Date of your flight
Time of your flight
Airline Company
Departing Airport
Arrival Date & Time of your flight
Name of pet (s)
Age
Sex
INTACT MALE
MALE NEUTERED
INTACT FEMALE
FEMALE SPAYED
Does your pet have a microchip
Yes
No
Date of Microchip implantation
Is your pet on heartworm prevention?
Yes
No
If so, please give us the name and date of the last does given.
Is your pet on flea/tick prevention?
Yes
No
If so, please give us the name and date of the last does given.
Date of last fecal test
Results of last fecal test
Email
*
example@example.com
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