Country to which the patient is traveling. *

When are they leaving the country and landing? *

Owner Details

Name of Owner (if different from who is traveling with pet, please write in as well and specify) *

First

Last

Phone Number *

Email Address *

Pet Information

Name of Pet *

Species *

Breed *

Sex *

Current Address with Phone Number

Current Address *

Phone Number *

Final Destination Address with Phone Number

Destination Address *

Phone Number *

Microchip number include date of implant

Microchip Number

Date of Implant

Signed rabies certificate with date of last vaccination, name of manufacturer, batch (serial) number, and date of when the next rabies booster is due and doctor’s signature- documents needed on day of visit. *

Click or drag a file to this area to upload.

Provide previous medical records and previous vaccine history PRIOR to visit. *

Disclaimer: Once this form and required documentation is received, one of our staff members will reach out to schedule an appointment.

Improper or incomplete paperwork for your pet can derail your travel plans, costing you valuable time and money.

PLEASE READ, PRINT, and SIGN that you understand the following:

For Domestic Travel (Within the USA)
Many states require an up-to-date Certificate of Veterinary Inspection from a licensed, accredited veterinarian when traveling. Your pet must be examined by a veterinarian in order for a health certificate to be issued. This certificate indicates that your pet is healthy for travel and that he or she is not showing signs of disease. This certificate is required by most airlines in order for your pet to travel within the continental United States. We strongly recommend contacting your individual airline to understand their specific travel requirements. Oftentimes airlines require that your pet be examined by a veterinarian and a health certificate issued within 10 days of travel. Check with your airline to ensure that your paperwork will be in order (THIS IS NOT OUR RESPONSIBILITY). If necessary we areable to add a certificate of acclimation to your pet’s travel papers. This certificate is written at the discretion of our veterinarians and is based upon our vet’s assessment of your pet’s health allowing him or her to travel above or below certain temperatures.

For International Travel (Outside the USA)

Many countries have their own pet health certificates and travel requirements, available at https://www.aphis.usda.gov/aphis/pet-travel
The International Health Certificate should be issued by one of our USDA certified veterinarians at Hoboken Vets Animal Clinic as near to the travel date as possible, but not more than 21 days before travel. The certificate should indicate the following:

Name of pet
Breed
Color
Age of pet
Country of origin
Name/address/phone number of the owner of pet
Confirmation that pet is healthy and free of parasites
Vaccinations given, including type, manufacturer, and batch number

Generally, the rabies shot must be given at least 30 days, but not more than 12 months, before travel, although some countries have different requirements. However, you must enter your destination country before your pet’s most recent rabies vaccination has expired. Along with an international health certificate, there may be additional requirements for traveling abroad. Please take some time to familiarize yourself with the international pet travel requirements specific to your destination prior to appointment (THIS IS NOT OUR RESPONSIBILITY). Improper or incomplete paperwork for your pet can derail your travel plans, costing you valuable time and money. If you have any questions, our staff at Hoboken Vets Animal Clinic is happy to help.
We schedule our appointments so that each patient receives the right amount of time to be seen by our physicians and staff. That’s why it is very important that you keep your scheduled appointment with us, and arrive on time.
As a courtesy, and to help patients remember their scheduled appointments [Practice Name] sends text message and email reminders in advance of the appointment time. If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those patients who are waiting for an appointment. As a courtesy to our office as well as to those patients who are waiting to schedule with the physician, please give us at least 24 hours notice. If you do not cancel or reschedule your appointment with at least 24 hours notice, we may assess a $93 doctor and $25 technician “no-show” service charge to your account.
I understand the “no-show” policy of Hoboken Vets Animal Clinic and agree to provide a credit card number, which may be charged $93/$25 respectively for any no-show of a scheduled appointment. I understand that I must cancel or reschedule any appointment at least 24 hours in advance in order to avoid a potential no-show charge to the credit card provided.

Pet Owner Signature *

Date *

International Health Certificate Form