International Health Certificate Worksheet
Please note that preparing for travel to some countries can take several months.
Complete this worksheet BEFORE your appointment. Our veterinarian needs the information in this document to complete your international health certificate.
Client Information
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
List the destination country you are traveling to with your pet.
Who is accompanying your pet while traveling?
The owner
A person authorized by the owner
No one
A 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 Flight
Air - Layovers in another country
Boat - Direct
Boat - Cruise ship
List the country or countries your pet will land in before the destination country is reached:
List all countries the cruise is stopping at:
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 and your pet arrive in the destination country? You? Your pet?
How many pets are traveling?
How old will the pet be at the date of travel?
What type of pet will be traveling?
Cat
Dog
Does your pet have a microchip?
Yes
Yes, but I don’t know when it was implanted.
I have more than one pet but not all of them have microchips.
No
I don’t know.
When was it implanted?
When was your pet’s last rabies vaccination?
The veterinarian issuing my international health certificate administered my pet’s last rabies vaccination.
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 know.
My pet isn’t vaccinated for rabies.
Date
Date
Does your destination country require an import permit?
Yes
No
I don't 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 certificate.
No.
Please verify that you are human
*
Submit
Should be Empty: