Health Certificate Appointment Request

Owner Name

Pet Name

Your Phone Number

Secondary Phone Number

Your Email

Destination, Exact address needed if known

Dates Traveling

How many pets will be traveling?

How old are they?

Species & Breed?

Date of last Rabies vaccine and what clinic was it was given?

Do you have the original Rabies Certificate?

Yes

N/A

Is your pet microchipped?

Yes

Was the microchip placed before the Rabies vaccine was administered?

Yes

N/A

List of all veterinarian clinic's your pet was seen at and their phone number?

I understand submitting this form does not guarantee an appointment. I understand that I will be notified after my submission is reviewed and approved for an appointment.

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Health Certificate Appointment Request

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