Online Form

Travel Health Certificate Questionnaire

Complete your travel health certificate questionnaire online from any device at any time before your visit.

Travel Health Certificate Questionnaire

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

"*" indicates required fields

Client Name:*

First Last

Name Patient:*

Date*

MM slash DD slash YYYY

Please be sure to fill this questionnaire out to the best of your ability and bring it along with you to your appointment.

List the destination country you are traveling to with your pet:*

Who is accompanying your pet while traveling?*

The owner

A person authorized by the owner

A pet transport company

No one

List the address(es) and phone number(s) where your pet will stay during their visit to the destination country.*

How is your pet leaving the United States?

Air – Direct Flight

Air – Layovers in another country

Car

Train

Boat – Direct

Boat – Cruise ship

If Air – Layovers: List the country or countries your pet will land in before the destination country is reached*

If Boat – Cruise ship: List all countries the cruise ship will be stopping in before the destination country is reached*

What date is your pet leaving the United States and from where (last air or seaport in the U.S.)?*

Please list the date your pet and the person accompanying them (if applicable) will arrive in the destination country:*

How many pets are traveling?*

How old will the pet(s) be at the date of travel?*

What species of pet will be traveling?*

Dog

Cat

Ferret

Bird (other than: chickens, doves, ducks, geese, grouse, guinea fowl, partridges, pea fowl, pheasants, pigeons, quail, swans, and turkeys)

Rodent

Hedgehog/tenrec

Rabbit

Reptile

Amphibian

Does your pet have a microchip?*

Yes

Yes, but I don’t know when it was implanted.

I have more than one pet but not all of them have microchips.

I don’t know

Microchip implanted on (date):

When was your pet’s last rabies vaccination?*

The veterinarian issuing my international health certificate administered my pet’s last rabies vaccination.

Another veterinarian administered my pet’s last rabies vaccination. I understand that I will need to bring their latest valid rabies certificate to my appointment.

I have more than one pet but not all of them have microchips.

I don’t know.

My pet isn’t vaccinated for rabies.

If selected option A, please list the date:*

If selected option B, please list the date:*

Does your destination country require an import permit?*

Yes

I don’t know

Did your airline or cruise ship give you any additional travel requirements for your pet?

Yes, I will bring this to my appointment.

This field is for validation purposes and should be left unchanged.

Have A Question?

Please use the information below to contact us. A member of our team will be in touch soon!



Contact

P: (610) 948-1014
E: contact@royersfordvet.com



Location

850 Main St. Royersford, PA 19468
Our parking lot is located off 9th Street.



Opening Hours

Mon & Wed : 8.00 am – 6.00 pm
Tues & Thurs: 8.00 am – 7.00 pm
Fri: 8.00 am – 5.00 pm
Sat: 8.00 am -12.00 pm

Name *

First

Last

Email *

Phone

How can we help you? *

Name