International Health Certificate Request Form

Legal Full Name

First NameLast Name
Will you be the one traveling with your pet? If not, please enter the name of the person traveling with the pet.

Other
Email
Please provide an email for all communications regarding this appt in case we are unable to reach you.
Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Pet's name
What is your pet's breed and coloring?
Please do not list MIXED as it is not an accepted breed into the countries.
List all countries that are planned for this travel.
What is your travel date?
When does your flight land?
Please list the date AND time
What is the purpose of travel?
Address in United States

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address in country you are visiting (if you are visiting multiple countries, please list the first one you are arriving):

Street Address

Street Address Line 2

CityState / Province / Country

Postal / Zip Code
Departing Flight Information - include Airline, Date, Time, Flight number, and departing airport.
If not booked, please let us know your expected travel day).
How is your pet traveling?

Other
Return Flight Information - include Date, time, flight # and departing airport
If not booked, please let us know your anticipated travel day. Leave BLANK if not returning with pet.
Is your pet microchipped?
Does your pet have an up-to-date Rabies vaccine?
Is your pet a service dog? (this does not include emotional or therapy animals)
Medical Records

Please submit FULL medical records including vaccinations & microchip implant to speed up the process.
Cancelof
Is there anything else we should know prior to your flight?
Please let us know if your pet gets anxious with flights, anything pertinent to the travel.
Signature
International Health Certificate Request Form
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