International Health Certificate Questionnaire
Please provide information below and we will contact you for an appointment.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What country are you traveling to?
Address at Destination
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Estimated Travel Date
-
Month
-
Day
Year
Date
Port of Embarkation (where are you leaving the US from?)
Mode of Travel (airplane, boat, etc.)
What other countries will you be travelling through on your way to your destination?
Visit Type
Permanent Relocation
Temporary Visit
Transit
How many pets are travelling?
Pet's Name (Pet #1 if more than 1)
Microchip Number (Pet #1)
Will you be accompanying your pet(s) during travel?
Please Select
Yes, I will be traveling with my pet(s)
No, my pet(s) will be shipped by a pet transport service.
Upload Rabies Certificate with microchip number & veterinarian's signature (Pet #1)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Vaccine History or Pet Passport (Pet #1)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Pet's Name (Pet #2 if applicable)
Microchip Number (Pet #2)
Upload Rabies Certificate with microchip number & veterinarian's signature (Pet #2)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Vaccine History or Pet Passport (Pet #2)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please verify that you are human
*
Submit
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