Dear Client,

Thank you for choosing Kierland Animal Clinic to assist with obtaining an international health certificate for your pet! To help us prepare and ensure we can complete everything on time, please take a moment to fill out the pre-questionnaire below. Your timely response will help us determine if we can meet your needs and schedule the necessary appointments.

Please keep in mind the timeline requirements of your destination country, as each country may have specific deadlines for health certification. We do require that your appointment must be scheduled at least 2 weeks before your scheduled departure date.

It may take up to 24 hours for us to reach out and schedule an appointment after receiving your completed questionnaire (unless the form is received after 5:30pm on Friday). We appreciate your patience and look forward to assisting you!

Your pet name *

Date(s) of birth *

Spay/neuter status(es) *

What airport will you be leaving from? *

Do you have any connections or are you traveling to any other countries between your point of origin and your destination? *

What is the destination country for your pet? (Please provide the full name of the country) *

What is the date of your planned departure for international travel? *

How many pets are traveling? *

breed? leaving vaccinations,

Airline *

Additional airline requirements

Are you personally traveling with your pet or is a third-party transporting your pet? *

I am traveling with my pet
A third-party is transporting my pet

What is your pet's species (e.g., dog, cat) and breed? *

Is your pet currently up-to-date on vaccinations, including rabies? *

Yes
No

If yes, please provide the vaccination dates *

Has your pet been microchipped? *

Yes
No

If yes, please provide the microchip number and date of implantation *

Has your pet undergone any recent medical treatments or procedures? *

Yes
No

If yes, please provide details *

Has your pet ever been diagnosed with a contagious disease or had any health issues that we should be aware of? *

Yes
No

If yes, please provide details *

Your full legal name as it appears on your passport *

First

Last

Email *

Phone *

Please provide your current US address *

Address Line 1

Address Line 2

City

State

Zip Code

If possible, please provide an address in the destination country

Address Line 1

Address Line 2

City

State

Zip Code

Previous veterinary clinic name and phone number for medical record retrieval

Please feel free to add any additional information or questions you may have regarding the international health certificate process

Upload any additional documents

Drag & Drop Files, Choose Files to Upload

Please keep in mind, airlines have different requirements in regards to pet travel. It is your responsibility to make sure you are compliant with the airline-specific rules and regulations. International Health Certificate services by Kierland Animal Clinic do NOT cover airline requirements for pet travel.

International Health Certificate Form

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