1.

If you would like to submit your travel information to our team online, please fill out this form below. A member of our team will get back to you within 5 business days to follow up.

*

Name:

First Required	Last Required

*

Email: Required

*

Phone Number: Required

If you respond and have not already registered, you will receive periodic updates and communications from The MSPCA-Angell.

*2.

Question - Required - Is your pet a current Angell Animal Medical Center patient?

Yes

This form is for existing Angell clients only. If you are not an existing client, please refer to the USDA website for a list of veterinarians.

*3.

Question - Required - Preferred method of contact:

Email

Phone

*4.

Question - Required - Full Home Mailing Address:

(Maximum response 255 chars, approx. 5 rows of text)

*5.

Question - Required - Pet's Name:

*6.

Question - Required - Species:

Cat

Dog

7.

Question - Not Required - Travel Dates (MM/DD/YY - MM/DD/YY or approximate):

(Maximum response 255 chars, approx. 5 rows of text)

*8.

Question - Required - Pets Age:

Month

Day

Year

*9.

Question - Required - Destination Country:

10.

Question - Not Required - Full address and phone number in the country of destination:

(Maximum response 255 chars, approx. 5 rows of text)

11.

Question - Not Required - Layover:

Yes

No

Unknown

12.

Question - Not Required - If yes, where:

13.

Question - Not Required - Are you leaving the airport during the layover? If so, you may need an international travel certificate for that country.

14.

Question - Not Required - Layover Duration

*15.

Question - Required - Is your pet up to date on vaccinations?

Yes

No

Unknown

*16.

Question - Required - Vaccination Records Available?

Yes

No

Please email the pet's rabies certificate, microchip certificate (if applicable), vaccine record, and name of the pet's primary care veterinary clinic to angellinternationaltravel@angell.org.

17.

Question - Not Required - Microchip ID number:

18.

Question - Not Required - Date given:

*19.

Question - Required - Have you spoken with a representative at the USDA?

Yes

No

*20.

Question - Required - Have you spoken with a representative at the consulate/embassy for the country of destination?

Yes

No

Any questions regarding government requirements should be directed to the USDA and the destination country's embassy or consulate.

*21.

Question - Required - Have you checked the requirements of your airline?

Yes

No

22.

Question - Not Required - Other questions or concerns:

(Maximum response 255 chars, approx. 5 rows of text)

We require all clients traveling internationally to please read and sign this International Travel Cert Agreement.

*23.

Question - Required - By submitting this form, I agree to the terms and conditions set forth in the International Travel Health Certificate Agreement (see attachment above).

I Agree.

*24.

Question - Required - Sign your name:

*25.

Question - Required - Add the date you signed

Month

Day

Year

Angell International Travel

We require all clients traveling internationally to please read and sign this International Travel Cert Agreement.