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Health Certificate Information

Fill out our form for health certificate information below!

Appointment

Health Certificate Information Form

Fill out the form below, and a member of our team will be in touch with you if we have any questions! Please Note: Any fields marked with * are required.

*Complete this form and return it to our office at least 48 hours before your health certificate appointment. Please review the list of additional documents required to complete the health certificate document that is located at the bottom of this form. You may bring these documents by in person or email them to info@urbanpawvet.com. Please keep in mind that health certificates for domestic travel (not including travel to Hawaii and other island territories) must usually be completed within 10 days of travel. International travel requirements (including Hawaii and other island territories) vary depending on the destination and can take weeks up to months of preparation; therefore, we recommend completing this form and scheduling an appointment in order to discuss all necessary steps prior to the health certificate appointment.

Today's Date *

Client Name *

Email *

Pet's Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number of Person Traveling with Pet(s) *

Email of Person Traveling with Pet(s) *

Date of Travel *

Airline *

Destination Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number of Person Receiving Pet(s) at Destination *

Email of Person Receiving Pet(s) at Destination: *

Previous Veterinarian *

Previous Veterinarian Phone Number *

Previous Veterinarian Email *

Health Certificate Information

Health Certificate Information Form

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