International Health Certificate Form

Pet Owner Worksheet for Preparing Visit with Accredited Veterinarian to Complete Health Certificate

Please note that preparing for travel to some countries can take several months.

Complete this worksheet BEFORE meeting with the USDA Accredited Veterinarian for the international health certificate. It is still your responsibility to check the USDA APHIS Pet Travel website to ensure you have the necessary documentation, vaccination(s), pre-travel bloodwork, and pre-travel treatments.

Specific requirements can be found at the following link: https://www.aphis.usda.gov/aphis/pet-travel

PLEASE FILL OUT THE BELOW QUESTIONS:

Name

Phone

Email

1. List the destination country you are traveling to with your pet

2. Who is accompanying your pet while traveling?

The ownerA person authorized by the ownerNo oneA pet transport company is transporting the pet

3. List the address(s) and phone number(s) in the destination country where your pet will stay during the visit:

4. How is your pet leaving the United States?

If Air - Direct Flight, please list your airline:

If Air- Direct Flight, please list your Flight #:

If Air - Layovers in another country, please list the country or countries your pet will land in before the destination country is reached:

If Boat - Cruise Ship, please list the country or countries that the cruise is stopping at:

5. What date is your pet leaving the United States and from where (last air or seaport in the U.S.)?

Date

6. Provide the date that you and your pet arrive in the destination country:

You

Your pet

7. How many pets are traveling?

8. How old will your pet be at the date of travel?

9. What type of pet will be traveling?

DogCat

10. Does your pet have a microchip?

Yes - I know implant date (see below)Yes - I don't know when it was implantedI have more than one pet but not all of them have microchipsNoI don't know

If you know your pet's microchip implant date, please provide below:

11. When was your pet's last Rabies vaccination?

The veterinarian issuing my international health certificate administered my pet's last Rabies.A veterinarian other than the veterinarian issuing my international health certificate administered my pet's last Rabies vaccination. I will need to bring the last valid rabies certificate to my appointment.I don't knowMy pet isn't vaccinated for Rabies

If the veterinarian issuing your international health certificate administered your pet's last Rabies vaccination, please provide the date:

If the veterinarian OTHER than the veterinarian issuing your international health certificate administered your pet's last Rabies vaccination, please provide the date:

PLEASE NOTE: If you are traveling to a country that requires a rabies titer, keep in mind that results for this test take a MINIMUM of 1 month.

I understand that it is my responsibility as the pet owner to review CDC requirements on rabies vaccination protocol for re-entry from the United States from a high-rish country. *

Please Initial

12. Does your destination country require an import permit?

YesNoI don't know

13. Does your pet have an EU (European Union) Pet Passport?

YesNoI don't know

14. Did your airline or cruise ship give you any additional travel requirements for your pet?

Yes, I will give this to the veterinarian issuing my international health certificateNo

15. There is a list of countries that allow the health certificate to be submitted electronically. That list can be found at https://www.aphis.usda.gov/aphis/pet-travel. Under the drop down option of "Choose your destination country", click the hyperlink titled "Country Acceptance List for VEHCS". Please continue below:

Does the destination country allow electronic signature?

Yes great! Stop hereNo - continue belowI'm still not sure - please re-read travel requirements carefully

If the destination country does not allow electronic endorsement:

Please obtain a prepaid express / overnight shipping label with YOUR address in the TO and FROM section (for example, FedEx or UPS).
You will need to schedule the health certificate appointment with enough time for the certificate to be returned. Do NOT wait until the day before travel.
Please bring the shipping label with you to the appointment.

I understand that Indian Trail Hospital takes guidance for health certificates and requirements for travel from the United States Department of Agriculture Animal and Plant Health Inspection Service (USDA APHIS). They make every effort to provide the appropriate requirements and timelines for my pet's health certificate, but I understand that it is ultimately my responsibility as the pet owner to know what is required and when for my pet to travel.*

Please Initial

I understand that airline requirements may be different than government requirements for pet travel. I understand that it is my responsibility as the pet owner to check the requirements/policies for the particular airline I may be traveling with. I will not hold Indian Trail Animal Hospital liable for any airline requirements/policies that were not met with my pet. Any additional costs or delays in travel that may arise due to not meeting airline requirements/policies are my responsibility as the pet owner. *

Please Initial

I understand that I am ultimately responsible for ensuring that requirements are completed in a timely manner and all proper forms are completed.*

Please Initial