총 230페이지

캐나다(상업용)
서식 9.6 ModelVeterinaryCertificateofHealth(Resale/Adoption)
Logo/Letterhead
Logo/Letterhead
ModelVeterinaryCertificateofHealth
ModelVeterinaryCertificateofHealth
ofIssuing
ofIssuing
[CountriesotherthantheUSA] [CountriesnotRecognizedasRabiesFree]
[CountriesotherthantheUSA] [CountriesnotRecognizedasRabiesFree]
VeterinaryClinic
[Resale/AdoptionEndUse]
VeterinaryClinic
[Resale/AdoptionEndUse]
ModelVeterinaryCertificateofHealthfortheExportofCommercialDogsLessthanEight
[COUNTRYOF ORIGIN]
VeterinaryCertificateofHealth
MonthsofAgetoCanadaforResale/Adoption
Healthinformation
CertificatereferenceNo.
Import permit No.
[COUNTRYOF ORIGIN]
VeterinaryCertificateofHealth
Consignor:
CertificatereferenceNo.:
Name:
Import permit No.:
Address:
I,theundersignedlicensedveterinariancertifythat:
Central competentauthority:
PartI:Detailsofdispatchedconsignment
1. Thekennel of originidentifiedabove,wherethedog(s) identifiedabovewas/werebornandhas/haveresided
Country:
from thetime of birth until export to Canada, hasbeen freefrom anyclinical, pathological or epidemiological
Consignee:
evidence of canine distemper, canine adenovirus 2 (hepatitis), canine parainfluenza virus and canine
Name:
parvovirusfor theninety(90)daysimmediatelyprecedingthedateof exporttoCanada.
Address:
2. Thekennel of originidentifiedabove,wherethedog(s) identifiedabovewas/werebornandhas/haveresided
from thetime of birth until export to Canada, hasbeen freefrom anyclinical, pathological or epidemiological
Country:
evidenceof rabiesforthesix(6)monthsimmediatelyprecedingthedateofexport toCanada.
Kennel of origin:
Meansof transport:
3. The dog(s) identified abovehas/havebeen vaccinatedagainst rabies, with a vaccine licensed and approved
Name:
PartII:Certification
Air ?
Land ?
Other?
for that purpose in [insert the country of origin], at least twenty-eight (28) days prior to the date of export to
Address:
Canada asshown below. The dog(s) identifiedabove was/wereatleast twelve (12)weeksof age atthetime
of rabiesvaccination.
Transport identificationnumber:
Country:
DATEOF
Countryof origin:
ISOcode:
Countryof destination:
ISOCode:
MICROCHIP
VACCINATION
VACCINENAME
MANUFACTURER
VACCINELOTNUMBER
NUMBER
CANADA
CA
(dd/mm/yyyy)
Number/Quantity:
Dateandtimeofdeparture:
Dogscertifiedfor:
Resale ?
Adoption ?
OR
Identificationof thecommodities:
Breed
Sex
Colour/Markings
Dateof Birth
MicrochipNumber andLocation
4. The dog(s) identified above has/have been vaccinated against canine distemper, canine adenovirus 2
(dd/mm/yyyy)
(hepatitis), canine parainfluenza, and canine parvovirus, with vaccines licensed and approved for that
purpose in [insert country of origin], at least twenty-eight (28) days prior to the date of export to Canada as
shownbelow. Thedog(s)identifiedabovewas/wereatleast six(6)weeksof ageatthetimeof vaccination.
DATEOF
DATEOF
MICROCHIP
VACCINE
VACCINELOT
PREVIOUS
VACCINATION
MANUFACTURER
NUMBER
NAME
NUMBER
VACCINATION
(dd/mm/yyyy)
(dd/mm/yyyy)
5. The dog(s) identified above has/have been treated for endo- and ectoparasites, with a broad-spectrum
product(s) licensed and approved for that purpose in [insert the countryof origin], during the seven (7) days
immediatelyprecedingthedateof export toCanadaasshownbelow:
DATEOF
PRODUCTNAME
MICROCHIP
TREATMENT
AND
ACTIVEINGREDIENT DOSEADMINISTERED
NUMBER
(dd/mm/yyyy)
MANUFACTURER
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