Travel Form | Central Veterinary Hospital

Pet Travel Information Form

Please complete this form to help us prepare for your pet’s upcoming travel.

Owner Information

Name(Required)

First Last

as it appears on passport

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Visiting Location(Required)

Downtown (Clinch Ave.)

Northeast (Mill Rd.)

Choto (S. Northshore)

Pet Information

Name(Required)

Full

Microchip Number

Species(Required)

Sex(Required)

Breed

Age

Weight

Color

Special Needs, Medical Conditions(Required)

Pet Vaccination Status

Vaccine History(Required)

Vaccine Name

Date Administered

Expiration Date

Travel Details

Departure Date(Required)

Airline(Required)

Departure Airport(Required)

Arrival Airport(Required)

Layovers

if any

Destination Information

Destination Address(Required)

Street Address Address Line 2 City State ZIP Code

Contact Person at Destination(Required)

First Last

Email(Required)

Phone(Required)

Acknowledgement

Signature(Required)

Date(Required)

Disclaimer

Central Veterinary Hospital and its staff are not responsible for flight delays, cancellations, schedule changes, or any travel documents other than the USDA Health Certificate. All travel is subject to USDA regulations and approval. Once all required documents are submitted, we are dependent on the USDA’s processing and endorsement timeline.