International Health Certificate Exam Information Form

Information for International Health Certificate Exams(Please note that preparing for travel to some countries can take months)

Name (First, Last)

Address (Physical)

State

City

Zip Code

Phone Number

Email Address

example@example.com

Pet Name

Species

Breed

Age/Date of Birth

Date

Microchip number (some destinations require microchip placement)

Destination Country

Address where your pet will be staying

Date of Travel

Date

Y /N Will your pet be returning to the US?

Which Airline will your pet be flying with?

Destination Country Requirements

***You must include your pet's vaccination history and Rabies certificate (two most recent vaccinations) with this application if the vaccines were NOT administered by Midway Veterinary Hospital.*** Medical records can be uploaded below.

File Upload

***Please note that some destinations require lab testing prior to entry. Samples will need to be collected within the testing timeframe required by your destination country and some tests may take a long time for the results to be returned. Some countries require a waiting period after testing and before entry into the destination country***

After your information 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.