International Health Certificate Request

Please fill out the following PRIOR to scheduling an appointment.
State to which the pet is traveling.*
Date when they are leaving the state*

MonthDayYear
What are the means of transportation?*
Health Certificate
Owner's Name*

First NameLast Name
Name of person traveling with the pet if not owner.

First NameLast Name
Primary Phone Number*
Please enter a valid phone number
Primary Phone Type*
Email*
example@example.com
Address of Pet’s Origin/Home*

Street Address

Street Address Line 2

CityState

Zip Code
Address of Pet’s Destination*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number you can be reached at your destination*
Please enter a valid phone number.
Departure Information
Date of Departure*

MonthDayYear
Pet Information

SECTION: Pet 1 Information
Name*
Species*
List Species Type
Sex*
Is your pet microchipped?*

YesNoNot sure
Microchip ID:
Does your pet have any known allergies or drug reactions?*

YesNo
If your pet has any known allergies or drug reactions, then please list them.
Is your pet currently being treated for any medical conditions?*

YesNo
If your pet is currently being treated for any medical conditions, then please describe them.
Has this pet had any previous medical problems or issues?*

YesNo
If your pet has had any previous medical problems or issues, then please describe them.
Name of current Heartworm/Intestinal Deworming Medication
Date of last Heartworm/Intestinal Deworming treatment

MonthDayYear
Name of current Flea/Tick Prevention
Date of last Flea/Tick Prevention treatment

MonthDayYear
Signed rabies certificate

Signed rabies certificate with date of last vaccination, name of the manufacturer, batch (serial) number, and date of when next rabies booster is due and doctor's signature-documents needed on the day of visit. (Not required to submit this form)
Cancelof

SECTION: Requirements
Requirements
Agreement*

I agree to the International Certificate Policy
Agreement: I understand that preparing for traveling can take months.

I understand that it is my responsibility to know the requirements and collect proper documentation for my pet’s travel.

I also understand that I cannot hold Huffard Animal Hospital or its employees accountable for any problems or difficulties processing said paperwork that may arise from processing, shipping or other situations, and that once the paperwork has left Huffard Animal Hospital -shipping and process times are no longer under the control of Huffard Animal Hospital.

By signing I am also accepting that there is a fee at the time of the appointment for a physical examination and the health certificate. Additional fees may occur. Any additional vaccinations, microchip placement, or lab tests that need to be done prior to my pet traveling overseas will be presented and discussed.
Printed Name for E-Signature*

First NameLast Name
Today's Date*

MonthDayYear
Are you a robot?*
Disclaimer: Once this form and the required documents are received, one of our staff members will reach out to schedule an appointment.

For Domestic Travel (Within the USA)
Many states require an up-to-date Certificate of Veterinary Inspection from a licensed, accredited veterinarian when traveling. Your pet must be examined by a veterinarian in order for a health certificate to be issued. This certificate indicates that your pet is healthy for travel and that he or she is not showing signs of disease. This certificate is required by most airlines in order for your pet to travel within the continental United States.

We strongly recommend contacting your individual airline to understand their specific travel requirements. Oftentimes airlines require that your pet be examined by a veterinarian and a health certificate issued within 10 days of travel. Check with your airline to ensure that your paperwork will be in order (THIS IS NOT OUR RESPONSIBILITY). If necessary we are able to add a certificate of acclimation to your pet’s travel papers. This certificate is written at the discretion of our veterinarians and is based upon our vet’s assessment of your pet’s health allowing him or her to travel above or below certain temperatures.
Should be Empty:

Health Certificate

Departure Information

Pet Information

Requirements