Owner Name:
*
Passport / Emirates ID:
*
Address:
*
City / Country:
*
Phone Number:
*
Pet Name:
*
Species / Breed:
*
Sex:
*
Color / Markings:
*
Date of Birth / Age:
*
Microchip Number:
*
VACCINATION STATUS / PARASITE TREATMENT
Vaccine Brand / Batch No:
*
Rabies Vaccine Valid Until:
*
Product Name:
*
Internal Parasite Treatment (Worming)
Date Administered:
*
Internal Parasite Treatment (Worming)
Product Name:
*
External Parasite Treatment (Ticks & Fleas)
Date Administered:
*
External Parasite Treatment (Ticks & Fleas)
CLINICAL EXAMINATION
Temperature:
*
Heart Rate:
*
Respiratory Rate:
*
General Health Status:
*
Animal examined and found clinically healthy
Free from visible infectious or contagious diseases
Fit to travel
Veterinary Declarations:
*
Yes
I hereby certify that the animal described above has been examined by me and found to be clinically healthy and fit for travel at the time of examination. This certificate is issued at the request of the owner for the purpose of animal travel.
Veterinarian Name
*
Date & Signature
*
Name
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