Interstate Health Certificate Request Form

Interstate Health Certificate Request Form

If your horse is traveling out of state, you are responsible for making sure you have all the proper documentation to cross specific state borders. All horses crossing any state border are required by law to travel with a valid coggins and a certificate of health. Some states also require proof of vaccination or entry permits. A wellness exam is required prior to the completion of the health certificate, please plan ahead and schedule an appointment prior to travel.

Owner Name

First Name

Last Name

Email

Name of horse(s) traveling and their temperature

Date of Departure

MM

DD

YYYY

Address of Origin

Where they are leaving from

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reason for travel

Name and phone number of destination

Address of Destination

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Transportation

Shipper Name, Address and Phone number

*if shipper not listed in above section