International Health Certificate Exam Information Form

Information form for livestock exhibition health certificates for in state movement. All informaton listed below is required prior to issuing health certificates.

Name (First, Last)

Address (Physical address where animal(s) are housed)

State

City

Zip Code

Phone Number

Email Address

example@example.com

Owner Premis Identification Number

Animal Name

Species

Breed

Sex

Color

Age/Date of Birth

Date

Official Identification Tag number and location

Other Tag/Ear Notch/Brand identification and locations

Initial Date of Travel

Date

List physical address of all shows planned or considered within 90 days of examination date.

Shows can be listed but not attended, however even though the certificate is valid for 90 days from the date of examination the certificate must be issued within 10 days of examination and can not be changed after that time. Additional shows can not be added, a new examination must be performed.

If someone other than the listed owner will be transporting include Name, Address, and Phone number.

***Please note that based on animal age and destination lab testing may be required for show entry. We will verify Florida Department of Agriculture rules regarding animal movement. You are responsible for providing individual show rules if parameters excede that of the state laws, please upload below.***

File Upload

After your application is submitted to Midway Veterinary Hospital, we will review it and get back to you as soon as we are able, depending on destination of travel and completeness of medical records provided the review process will take between 24 and 48 business hours. We appreciate your patience.