Health Certificate Questionnaire

Save time during your appointment! Complete your Health Certificate Questionnaire online from any device at any time before your visit.

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Name *

First

Last

Email *

Phone Number *

Pet's Name *

Species *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

What country are you traveling to? *

Port of Entry *

Permanent or Temporary Admission? *

Date of Departure *

Port of Departure/ Airport *

Address in traveling country *

Who is traveling with your pet? *

Is your pet current on Rabies? *

Do you have a signed copy of the Rabies Certificate? *

Date *

Name

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