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As there is a significant amount of preparation work and time devoted to international health certificate appointments this form is required to be completed prior to any IHC appointment scheduling to ensure your understanding and agreement of our policies.

If you are traveling with multiple pets, only one consent form is required.

Client Information

First Name*

Last Name*

Email*

Phone*

Pet or Pet's Names*

Address of the Destination

Details of the Persons who are travelled with you

Additional Information/Questions for the upcoming travel

Consent*

I understand.

I understand that Companion Lake Zurich advises for pet travel based on USDA recommendations – if I have been informed of other requirements I understand these should be relayed to the Pet Travel Coordinator.

Consent*

I understand.

I understand USDA endorsement can take up to 5-7 business days – plus time for shipment – and Companion Lake Zurich does not have control of certificates/processing time once submitted to the USDA. I understand there is no “expedited” processing offered by the USDA for endorsement.

Consent*

I understand.

I understand it is Companion Lake Zurich’s responsibility to ensure the health certificate is completed correctly and the owner’s responsibility to ensure necessary appointments are scheduled in a timely manner to fulfill all requirements specific to the destination country and required paperwork is submitted prior to the appointment.

Consent*

I understand.

If you are new to our hospital or have received vaccines at another facility, please remember to bring your pet’s medical history, proof of vaccines (including rabies vaccination), rabies certificate, and proof of microchip to your appointment. Failure to provide these documents at the time of the appointment may result in delays or prevent us from completing the international health certificate.

I understand the USDA has issued the following statement (Companion Lake Zurich is able to monitor the status within the USDA system but direct status updates from the USDA are not available):

In-person endorsement services are not available at this time.

Our offices are closed for all federal holidays listed on the Office of Personnel Management’s webpage.

We are working to endorse health certificates received by shipping and VEHCS as quickly as possible. As always, errors or problems with your submission will result in a delay in endoresement. We will contact the owner/exporter and/or the USDA Accredited Veterinarian promptly if problems are found with the submission. If you are shipping a health certificate to or from our office, we recommend you use overnight delivery services with Saturday delivery.

We regret time does not permit us to reply to requests for confirmation of delivery or status reports on your health certificate since we must remain focused on endorsement of health certificates to get them back to you as quickly as possible. For shipped packages, use your package’s tracking information to confirm delivery and that your endorsed health certificate is en route back to you. For VEHCS packages, the accredited veterinarian can monitor the status of the submission within the system.

Consent*

I understand the above statements.

Consent

I understand.

I understand that IHC’s scheduled within 2 business days of the appointment incur a $300 Rush IHC Preparation fee and IHC’s scheduled within 5 business days of the appointment incur a $230 Rush IHC Preparation fee. These fees are in addition to the regular cost of a health certificate.

Consent*

I understand.

I understand if a “regular” appointment is not available and I am required to book an “urgent care” appointment that the urgent care fee will also apply in addition to any other charges.

Consent*

I understand.

I understand that a Rush IHC Preparation fee may also be charged if proper paperwork and documentation are not submitted to Companion Lake Zurich at least 5 days prior to the appointment.

I understand a signed, valid rabies certificate is required to be on file prior to scheduling the health exam.
A signed, valid rabies certificate includes the following:

Dr.’s signature and license number
Date of vaccination and when vaccine is next due
Vaccine product expiration date
Vaccine manufacturer and product name
Vaccine batch number
Pet’s name, age, breed, and color
Certificate must be in English or with full English translation
If a microchip is listed as a requirement for the country of travel, the microchip must be listed on the rabies certificate.

Consent*

I understand the above statements.

Consent*

I understand.

I understand if I am unable to provide the above noted signed, valid rabies certificate that my pet will need to be revaccinated against rabies in order to have a valid certificate/vaccine for the health certificate/endorsement.

Consent*

I understand.

I understand that if my pet will be travelling through multiple countries more than one health certificate may be required and will incur the full cost of an additional certificate. The Pet Travel Coordinator should be made aware of this ASAP!

Consent*

I understand.

I understand that if ANY vaccinations, testing or health-related issues need to be addressed these MUST be done at a separate visit from the international health certificate exam. These services will incur additional charges based on what is required for the country you are traveling to.

Consent*

I understand.

I understand that there is a $110 non-refundable deposit required for booking. There will be a $25 charge for rescheduling International Health Certificate appointments less than 5 days in advance and canceling (at any time) does forfeit the $110 deposit.

If you are working with a pet shipping company – I understand the following:*

If Companion Lake Zurich is completing and signing off on the health certificate, Companion Lake Zurich’s USDA VEHCS account must be used.

Pet shippers may send completed certificates for reference only – Companion Lake Zurich will complete all health certificates on their own.

ALL paperwork (vaccines, testing, import permit) must be submitted prior to the appointment or Companion Lake Zurich is unable to complete the exam. Expedited fees apply if received less than 5 days to appointment date.

The owner will need to complete this consent form and any other paperwork related to the IHC so they are aware of and legally acknowledging any policy, timelines, and pricing.

By signing below, I agree to all of the above policies*

Date*

MM slash DD slash YYYY

After completing this consent form, you are able to give the clinic a call for scheduling.

Name

This field is for validation purposes and should be left unchanged.

IHC Policy Consent Form

Client Information

What's Next

Call us or schedule an appointment online.

Meet with a doctor for an initial exam.

Put a plan together for your pet.

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