International Health Certificate Consent Form International Health Certificate Consent Form Name * Name First First Last Last Pet's Name * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * At Shepherd of the Hills Veterinary Clinic (SHVC) our doctors are certified by the USDA APHIS (Animal Plant Health Inspection Service) to examine and prepare dogs and cats for international travel. This requires our doctors to maintain continuing education in accordance with the state and federal regulations as well as generate a substantial amount of paperwork that many times must be endorsed. This process is very demanding of the DVM’s time. I understand that there may be MULTIPLE veterinary visits depending on the destination country and the time frames for these visits are crucial. Any failure to show up for the visits may result in my pet not being able to travel. * I understand I understand that certain vaccine and vaccine time lines are required that may go against the vaccine protocol I want for my pet but if I want my pet to travel internationally there is no negotiation and the vaccines will be performed and sometimes repeated at particular intervals based on a countries requirements. * I understand I understand that there may be information the veterinarian may require me to obtain and failure to obtain said information in a reasonable time frame may delay the health certificate and result in my pet being unable to travel. * I understand I understand that even though I and the veterinarians at SHVC may do everything exactly correct we are at the mercy of the state veterinarian and sometimes they will reject a health certificate or delay it which can result in my pet being unable to travel. * I understand I understand that this does not guarantee my pet’s travel internationally and all veterinary clinic fees are due at time of service and non-refundable for any reason. * I understand Signature of owner or owner representative * signature keyboard Clear Date * Captcha Submit If you are human, leave this field blank.
