International Health Certificate Inquiry

Name: Veterinarian
Brand: Downers Grove Animal Hospital

Thank you for inquiring about international travel with your pet(s). In order for us to prepare your International Health Certificate(s) for travel we kindly ask that you fill out this form provided in its entirety and accurately. A member of our staff will contact you to review the requirements of the country you are visiting and any additional information that may be needed.

Today's Date

Name of person traveling with pet

First Name

Last Name

United States Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

Your Email Address

What type of animal are you traveling with?

What country are you traveling to?

Date of Departure

International Address (where pet will reside)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone number where pet will reside internationally. (can be same as person traveling with pet, ie. cell phone)

Is your pet returning with you to the United States?

Does your pet have an international microchip implanted? (15 digits)

Is your pet current on vaccinations? Specifically Rabies? Please provide types and dates of all vaccinations.

If Downers Grove Animal Hospital is not your primary veterinarian, please provide the phone number of the animal hospital where we can obtain records.

The USDA has specific requirements for submission of International Health Certificates which include but are not limited to:

· The ORIGINAL International health certificate

· Vaccination certificates (if vaccination required by the destination country)

· Test results for laboratory tests (if required by the destination country)

· Import permit (if required by the destination country)

. CDC import permit (if returning to the USA)

· Payment to process certificate (not included in our examination fee)

· Pre-paid express shipping labels at the owners expense.

Give adequate time and proper planning for the endorsement of your health certificate. Incomplete submissions or incorrect information on health certificates will cause endorsement delays until the USDA Accredited Veterinarian or the owner/exporter of the animal can correct the problem. Endorsement of a correctly completed health certificate can take upwards of 3 business days.

I understand that I am responsible for researching all of the requirements my travel country requires and the airline my pet will travel on. I understand that I am responsible for submitting all non-electronic paperwork completed by Downers Grove Animal Hospital to the USDA for endorsement. I understand that once my paperwork leaves Downers Grove Animal Hospital we are no longer responsible for its endorsement and return. I understand that a $100 NON REFUNDABLE deposit will be taken at the time of scheduling my International Health Certificate Appointment to prepare your documents.

Yes

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International Health Certificate Inquiry

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