Application for International Health Certificate Exams

Application for International Health Certificate

*Please note that preparing for travel to some countries can take months and will require multiple visits. A $63 non-refundable deposit is required to review export requirements, patient records and set up a recommended schedule catered to your travel requirements and timeline.*
*** Some countries require vaccine titer samples which 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***
Client Information and Travel Arrangements:
Name*

First NameLast Name
Is this the name of the person traveling with your pet(s)*

YesNo
Name of the person traveling with the pet(s)*

First NameLast Name
Address (P.O. Boxes are not accepted)*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
(U.S. Phone Number)
Email Address*
example@example.com
Destination Country*
Expected Date of Travel*

MonthDayYear
Date
Will you be landing in a country other than your destination country?*

YesNo
What country is the initial port of entry?
International Address (This will be required prior to the final appointment)*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Additional travel destinations
Please list any other countries you plan on visiting with your pet
International Phone Number*
Please enter the phone number you can be reached at in your destination country (this can be the same as your US phone number
Which Airline will your pet be flying with?
Does your airline have any of its own specific requirements?
Any forms required by your airline that will need to be filled out or signed by the doctor may be submitted with this application.
Will you be returning to the U.S.A. with your pet?*

YesNo
Expected date of return

MonthDayYear
Date
Will you be returning to a different address with your pet?

YesNo
Return address (P.O. Box not accepted)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Patient Information
Name*
Species*
Breed*
Color*
Date of Birth*

MonthDayYear
If date of birth is unknown please enter an estimated date of birth.
Microchip number*
An ISO - microchip is required for most countries, please enter N/A or Unknown if your pet does not have a microchip or you do not know your pet's microchip number
Has your pet received any vaccinations, testing or preparation for travel at another veterinary facility?*

YesNo
Please list the name of any veterinary facility that our pet received vaccinations, testing or preparation for travel.
Patient documents

Please upload any medical records, vaccine certificates, test results or other documents that may be useful to prepare your pets health certificate
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Would you like to add another pet to this application?*

YesNo
Name
Species
Breed
Color
Date of Birth

MonthDayYear
If date of birth is unknown please enter an estimated date of birth.
Microchip number
An ISO - microchip is required for most countries, please enter N/A or Unknown if your pet does not have a microchip or you do not know your pet's microchip number
Has your pet received any vaccinations, testing or preparation for travel at another veterinary facility?*

YesNo
Please list the name of any veterinary facility that our pet received vaccinations, testing or preparation for travel.
Patient documents

Please upload any medical records, vaccine certificates, test results or other documents that may be useful to prepare your pets health certificate
Cancelof
***You must include your pet's vaccination history and signed Rabies certificate(s) with this application if the vaccines were NOT administered by Issaquah Veterinary Hospital***
After your application is submitted to Issaquah Veterinary Hospital, we will review it and get back to you as soon as we are able. We appreciate your patience.
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Application for International Health Certificate

Client Information and Travel Arrangements:

Patient Information