Application for Health Certificate for travel within the United States of America

Application for Health Certificate for travel within the United States of America

*Please note that preparing for travel outside of the continental United States can take months and will require multiple visits. A $63 non-refundable deposit is required for health certificates to states / territories such as Hawaii, the District of Columbia, Guam, and Puerto Rico in order to review export requirements, patient records and set up a recommended schedule catered to your travel requirements and timeline.*
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
Washington State 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 State*
If traveling by airplane please list the state you are landing in.
Expected Date of Travel*

MonthDayYear
Date
Destination Address (This will be required prior to the final appointment)

Street Address

Street Address Line 2

CityState

Zip Code
Means of transport*
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.

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
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
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.
Should be Empty:

Application for Health Certificate for travel within the United States of America

Client Information and Travel Arrangements:

Patient Information