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Travel Appointment Questionnaire
Welcome to Yonge & St. Clair Veterinary Hospital!
3
Travel Appointment Questionnaire
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Client Information
Title:
*
Mrs.
Mr.
Ms.
Dr.
Name
*
First
Last
Email
*
Patient Information
Name
*
Birth Date (or age if unknown)
*
Sex
Male
Female
Breed
*
Colour
*
Microchipped?
*
Yes
No
Don’t Know
What date were they microchipped? (if known)
*
Where were they microchipped?
*
Yonge & St. Clair Veterinary Hospital
Another Vet/Breeder/Rescue
Travel Appointment Information
Destination
*
Travel Date
*
Will you be moving there permanently?
*
Are you interested in a mild sedative for the trip?
*
Is microchipping required by the country?
*
Yes
No
Don’t Know
Is rabies titer testing required by the country?
*
Yes
No
Don’t Know
Is deworming required by the country?
*
Yes
No
Don’t Know
Most pets traveling from Canada to another country will need an export certificate issued by a licensed veterinarian and endorsed by an official Canadian Food Inspection Agency (CFIA) veterinarian.
*
I understand
Does the country require endorsement by the CFIA?
*
Yes
No
Don’t Know
If yes, have you made an appointment? (Include date of appt)
If you answered ‘I don’t know’ to any of the above, please call the CFIA Markham Office at 905-513-2850 to confirm what is required for entry.
*
I agreed and understand
Client Signature
Signature
*
Clear Signature
Date
*
Comment
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