International Pet Travel Clearance Form

Owner Information

Full Name

Passport Number

Address

Phone Number

Email

Pet Information

Pet Name

Species

Breed

Age

Sex

Microchip No.

Travel Details

Departure Country

Destination Country

Departure Date

Arrival Date

Method of Transport

Vaccination & Health

Vaccination Details

Health Certificate Issued By

Certificate Date

Declaration

Declaration and Signature

Owner Signature

Date