International Health Certificate Pre-Visit 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 who needs this information to complete your international health certificate.
Client Name*
Pet Name*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Has your pet been to GAVH before?*
List the destination country you are traveling to with your pet.*
Who is accompanying your pet while traveling?*

The ownerA person authorized by the ownerNo oneA pet transport company is transporting the pet
List the address(s) and phone number(s) in the destination country where your pet will stay during the visit.*
How is your pet leaving the United States*

Air– Direct FlightAir- Layovers in another country (list below)*Boat - List port of entry (list below)**
*If Air- layovers - List the country or countries your pet will land in before the destination country is reached
**Boat- port of entry
What date is your pet leaving the United States and from where (last air or seaport in the U.S.)?*
Provide the date that YOU (OWNER) will arrive in the destination country*
Provide the date that YOUR PET will arrive in the destination country*
How many pets are traveling?*
How old will the pet(s) be at the date of travel?*
What type of pet(s) will be traveling?*

DogCatOther
Does your pet have a microchip?*

Yes (input date implanted and number below)Yes, but I do not know when it was implantedI have more than one pet but not all of them have microchipsNo
Date microchip implanted

MonthDayYear
Date
MICROCHIP NUMBER
When was your pet's last rabies vaccination?*

The veterinarian issuing my international health certificate administered my pet's last rabies vaccination (Provide date below)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 2 valid rabies certificates to my appointment (Provide date below)I do not knowMy pet is not vaccinated for rabies
Last rabies vaccination date

MonthDayYear
Date
Do you require a rabies titer test?*

Yes and I have the results in handYes but I need testing doneNo
Does your destination country require an import permit?*

YesNoI do not know
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
Starting on August 1, 2024, dogs returning to the United States must meet new, specific requirements depending on where they have been in the 6 months before entering the United States and where they received their rabies vaccines (if required). Will your dog(s) return to the United States within 6 months of international travel?*

YesNoUnsureNot Applicable (Feline Patients)
IMPORTANT!

Upon submission of this form, you will be redirect to the USDA's website for Animal and Plant Health Inspection Service. Each destination country has their own set of requirements that pet owners need to be aware of. It is the pet owner's responsibility to make sure their pet has met the requirements of the destination country. Failure to meet the requirements may result in problems gaining certificate endoresement (when required) or difficulties upon arrival in the destination country.
Should be Empty:

IMPORTANT!