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International Travel Form

Disclaimer

PAYMENT IS REQUIRED IN FULL AT THE TIME SERVICES ARE RENDERED. ACCEPTABLE FORMS OF PAYMENT ARE CASH, AMEX, VISA, MASTERCARD, DISCOVER, CARECREDIT, AND SCRATCHPAY (CHECKS WILL NOT BE ACCEPTED).

Full Name

Street Address

City

State

ZIP Code

Phone

Email

Pet Name

Pet traveling via

Pet traveling via
A
B

Pet's travel date

Date of travel:

Date of travel:
A
B

Pet will be traveling with:

Pet will be traveling with:
A
B
C

Will pet be returning to the US?

Will pet be returning to the US?
A
B

Address where pet will be staying (destination address)

Destination Street Address

City

State / Province / Region

ZIP / Postal Code

Country

Any other information we need to know at this time? e.g. I am currently abroad, contact preference (email, phone, text)

Please attach all relevant records (any vaccination records, especially rabies vaccination; microchipping records, and previous rabies titers)

I hereby acknowledge that I (or a consignor on my behalf) have reviewed and confirmed the accuracy of the entirety of the information listed above. This information will be used to issue a health certificate to the country listed on the date noted above.
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I, understand that the FedEx delivery time is not under the control of West Hills Animal Hospital. I acknowledge that unforeseen circumstances may delay my document or result in it not arriving on time, although I am paying for overnight shipping. I agree to wait until the hospital notifies me that the document has been delivered to their office and is ready for pick up.
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​Disclaimer:
Once endorsement materials or requests are submitted to the United States Department of Agriculture (USDA), the review and approval process is entirely under the USDA’s control. We cannot influence, expedite, or guarantee the outcome, timing, or decision of any USDA endorsement. All determinations are made solely at the discretion of the USDA.

Owner Signature

Signature