International Health Certificate

[ Name of person traveling with pet ] (as it appears on their passport) *

[ Pets Name ] *

[ Microchip number ] *

[ Microchip implant date ]

[ Your Email ] *

[ Phone Number ] *

[ Where you are traveling to ] *

[ Address in US ] *

Street Address *

Apt/Suite/Other

City *

State *

Zip Code *

[ Address Abroad ] *

[ Airport leaving from ] *

[ Date of departure to destination ] *

[ Vaccination records & rabies vaccination certificate signed by a licensed veterinarian ]

[ Microchip information (if applicable) ]

[ Your Message ]

* Please attach any current vaccination records, as well as a RABIES CERTIFICATE signed by an accredited veterinarian and microchip information (if applicable) AND brought in during your appointment.