Health Certificate Travel Request

Health Certificate Travel Request

International Travel Certificates requests cannot be processed less than 60 days in advance. There are extensive planning and preparations that must occur. Interstate Travel Certificates cannot be processed less than 30 days in advance. Please visit the USDA Pet Travel website to see the state restrictions for pet entry. Each state has it's own requirements for pet entry. These are not the same as airline travel forms.
Owner Information - LOCAL
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *
Owner Information - DESTINATION
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *
Are you the person who will be traveling with the pet(s)? *

Yes No
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Phone Number *
Pet Information
Pet's Name *
Pet's Breed *
Sex *

Male Female
Is your pet spayed/neutered? *

Yes No
Does your pet have a microchip? *

Yes No
Add More Pets?

Yes No
Pet's Name
Pet's Breed
Sex

Male Female
Is your pet spayed/neutered?

Yes No
Does your pet have a microchip?

Yes No
Add More Pets?

Yes No
Pet's Name
Pet's Breed
Sex

Male Female
Is your pet spayed/neutered?

Yes No
Does your pet have a microchip?

Yes No
Travel Information
Date of departure *

Month Day Year
Date
Method of travel *

Airline - Cabin Airline - Cargo Vehicle Other
Other: *
Airline Name and Flight Number *
Port of Departure (if applicable)
Destination Port of Entry (if applicable)
For specific travel requirements for Interstate and International travel, please visit the USDA Pet Travel website. It is the responsibility of the owner to be aware of the requirements for pet entry. *

I have read and understand
Submission of this form does not guarantee East Lansing Veterinary Clinic staff and doctors will be able to complete the travel certificates as requested. A team member will review your request and discuss with you directly. *

I have read and understand
East Lansing Veterinary Clinic staff and doctors are not responsible for final entry into your destination. All paperwork is submitted to USDA and destination local authorities prior to travel. Any entry concerns will need to be directed to the authorities at your destination. Accepted entry of your pet(s) into your destination is at the will of destination authority and East Lansing Veterinary Clinic is not liable for any issues. *

I have read and understand
Signature *

Clear
Date

Month Day Year
Date
Should be Empty:

Health Certificate Travel Request

Owner Information - LOCAL

Owner Information - DESTINATION

Pet Information

Travel Information