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Home » International Health Certificate Form

International Health Certificate Form

Health Certificate Information — Owner To Complete

Please make sure to visit the USDA website https://www.aphis.usda.gov/pet-travel as well as the airline website for all protocols

DEPARTURE DATE:(Required)

MM slash DD slash YYYY

Pet's Name:(Required)

Owner’s Origination (Local) Address

Owner's Name Travelling With Pet(Required)

Address 1(Required)

Address 1

City/State 1(Required)

Zip Code 1(Required)

Country 1(Required)

Phone Number 1(Required)

Email Address 1(Required)

Owner’s Destination Address

Owner's Name (if different from person travelling with pet)

Address 2(Required)

Address 2

City/State 2(Required)

Zip Code 2(Required)

Country 2(Required)

Phone Number 2(Required)

Email Address 2(Required)

Purpose of Movement

Travel/Temporary Visit

Relocation/Moving

Sale

Exhibition

Other

Movement Other Details

Method of Travel

Airline

Car/Truck

Boat

Other

Other Travel Details

Airline/Flight Information

Airline:

Flight Information:

Click to Attach Medical Records/Vaccine History/Other Document

Max. file size: 50 MB.

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(847) 854-8387

230 Stonegate Rd.,
Algonquin, IL 60102

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