Owner Information

Full Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Pet Information

Pet's Name: *

Species: *

Breed: *

Age: *

Sex: *

Intact Male
Neutered Male
Intact Female
Spayed Female

Microchip Number (if applicable):

Rabies Vaccination Date: *

Rabies Certificate Number: *

Other Vaccinations (include type and dates): *

Travel Information

Destination Country: *

done? (if list

City of Arrival: *

Countries transited through (if any):

Departure Date: *

Return Date (if applicable):

Airline(s) and Flight Number(s):

Will the pet be traveling:

In-cabin
As checked baggage
As cargo

Is the pet traveling:

Alone
With a Person

Name of traveler accompanying the pet (if different from owner):

Timeline and Preparation

Desired Date for Health Certificate Appointment: *

Does the destination country require:

An import permit?
Specific parasite treatments (fleas, ticks, internal worms)?
Rabies titer test (FAVN)?

Has a rabies titer test been done? (If yes, please list Date and Laboratory)

Is there a USDA-accredited veterinarian involved? (If not, one may be required for endorsement)

Is USDA endorsement required for your certificate?

Do you need help arranging the USDA endorsement process?

Have you reviewed the import requirements for your destination country?

Yes
No
I need assistance

Additional Information

Is this your first time traveling internationally with a pet?

Are there any known medical conditions or special needs?

Will the pet need sedation for travel? (Note: Not generally recommended)

Any special travel crate or carrier requirements?

Do you need help with airline-approved crate sizing or preparation?

Do you need assistance with travel documentation for re-entry into the U.S.?

Signature & Consent: I certify that the above information is accurate to the best of my knowledge and understand that it is my responsibility to ensure all international entry requirements are met. *

Clear Signature

Today's Date *

International Health Certificate Questionnaire

Owner Information

Pet Information

Travel Information

Timeline and Preparation

Additional Information