"*" indicates required fields

** Failure to provide medical records/vaccine history may prevent/impede your ability to travel with your pet at your desired departure time.**

Client Information

First Name*

Last Name*

Email*

Phone*

Spouse's Phone

Address

Street Address

Address Line 2

City

State

ZIP Code

Pet Information

List Pets*

Pet Name

Species

Breed

Color

Age

Microchip #

Date of Microchip Implantation

To add another pet, please click the plus symbol

Please submit any previous medical records/vaccine information for veterinary care not performed by our hospital.

Max. file size: 50 MB.

Information Our Veterinarians Need to Know Before Completing Your Pet's International Health Certificate

Where is your pet going (destination country)?*

Who will be traveling with the pet?*

The Owner

A Person Authorized by the Owner

A Pet Transport Company is Transporting the Pet

Will your pet be flying in cabin or under in cargo?*

Cabin

Cargo

What is the address in the destination country where your pet will be staying?*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

What date is your pet leaving the United States?*

Will you be leaving the country ahead of your pet’s departure?*

Yes

Are you traveling out of state with the pet prior to leaving the country?*

Yes

What Date is your pet arriving in the destination country?*

What airline will you be using?*

Check with your airline to determine what requirements they have, if any. Airlines may have separate and additional requirements from those of your destination country.*

I have checked

I have not checked

Please Consult the APHIS Pet Travel Website for this Information Prior to Scheduling Your Appointment

What type of health certificate is required?*

A country-specific health certificate / A generic pet certificate (ex: APHIS 7001)

When must a physical exam of the pet(s) be performed prior to travel?*

Note: Most countries require a physical exam be performed by a veterinarian within 10 days of travel.

Is a microchip required?*

Yes

Is a specific type of microchip required?*

Yes

If so, what one?*

Does your destination country require specific vaccines or vaccine titers (blood testing)?*

Vaccine or Titer Name

Do they require a specific time line for these vaccines or vaccine titers prior to travel?*

*NOTE: You must have signed rabies vaccine certificates for all rabies vaccinations documented on the health certificate. These vaccination certificates will be required by the USDA at the time of health certificate endorsement. They should also accompany the pet during travel. The microchip number must be TYPED on the rabies certificate to prove that it was that pet who received the vaccine.*

I understand

Are any laboratory tests required by your destination country?*

Yes

Are any treatments (e.g. topical flea and tick prevention or deworming medications) required by your destination country?*

Yes

*NOTE: Laboratory tests or treatments required by the destination country will be an additional charge (not included in the cost of your pet’s physical exam and health certificate submission). The USDA department reviewing and endorsing your pet’s health certificate may also charge an additional fee for assessing test results.*

I understand

Re-Entry to the US: If you intend to bring your pet back into the U.S, there may be certain
re-entry requirements, depending on where you traveled. You should plan for them now.
See the Pet import section for details.Work with your veterinarian to complete all required paperwork for re-entry. Please consult the APHIS pet travel website to access the required certificate/form, when applicable.

After your pet’s exam & health certificate have been completed, signed, and dated by your
veterinarian, most countries require that international health certificates be submitted to a USDA
APHIS Veterinary Services office for endorsement. They will review the full certificate and any
attached/required paperwork. If all requirements are met, they will endorse the certificate and
mail it directly to you. If they find any issues with the certificate or find that the requirements to
travel to that country are not met, they will alert us for correction & resubmission before they
endorse the certificate.

Because this endorsement with USDA APHIS is required by most destination countries, it is in
your best interest to ensure your exam appointment is 9-10 days prior to travel to allow enough
time for the certificate to be endorsed by the USDA and sent back to you prior to departure.

Signature*

Date*

Name

This field is for validation purposes and should be left unchanged.

International Health Certificate Questionnaire

Client Information

Pet Information

Information Our Veterinarians Need to Know Before Completing Your Pet's International Health Certificate

Please Consult the APHIS Pet Travel Website for this Information Prior to Scheduling Your Appointment