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Model Veterinary Health Certificate for the Import of U.S returning Pet Birds into the United States from countries 

affected with Highly Pathogenic Avian Influenza

Veterinary Authority Date Of Issue Health Certificate Number 

CERTIFICATION

Section A. Completed by the Issuing or Authorized Veterinarian

1. Consignor/Shipper/Owner:

Name:

Address:

Country

2. Consignee/Broker/Owner:

Name:

Address:

Country

3. Country of Export 4. Date of Shipment:

5. Country Of Destination:

USA

6. Destination State:

7. XXXXXXXXXXXXXX 8. Port Of Embarkation / (city and port):

9. Description of Commodity:

 Pet

10. Means Of Transport:

11. Commodities Intended Use:

 Pet

12. XXXXXXXXXXXXXXX

13: Total Number Of Shipping Containers: 14. XXXXXXXXXXXXXXXXXXX

15. Identification Of Birds:

Row Name /Identification Species/Breed Physical Description Age

Months/years

Weight

(gms)

Sex

 1

2

3

4

5

Note: Shipments of birds which are 5 or less are considered as “pet bird shipments.” Shipments of birds with 6 or more are

considered commercial shipments and must use a different health certificate.
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Model Veterinary Health Certificate for the Import of U.S returning Pet Birds into the United States from countries 

affected with Highly Pathogenic Avian Influenza

XXXXXXXXXXXXXXXXXXXXXXX

XXXXXXXXX

Date Of Issue Certificate Number 

Section B. The issuing /official veterinarian certifies for export that all pet birds covered by this certificate have been inspected within 30 

days of the issuance date of this document and attests to the following statements: 

_____________________________________________________________________________________________________________

1. The bird(s) is/are exported in accordance with the laws of the exporting country. 

2. There was no evidence of communicable diseases of poultry upon examination of the bird(s). 

3. The bird(s) covered by this certificate does/do not originate from flocks nor had contact with any birds or 

poultry originating in a control zone established by state/provincial/federal animal health authorities due to 

outbreaks of Newcastle disease or Highly Pathogenic Avian Influenza (HPAI) in the previous 90 days.

4. The bird(s) was/were not vaccinated against any H5 or H7 subtype of avian influenza. 

5. CHOOSE EITHER OPTION (a) OR (b) BELOW: (strike out that which does not apply)

(a). The bird(s) was/were not vaccinated against Newcastle disease

 OR

(b). The bird(s) has/have been vaccinated against Newcastle disease (avian paramyxovirus) at least 21 days prior 

to export, using vaccines that do not contain any velogenic strains of Newcastle disease virus. 

 

 

 

6. The birds were placed in new or appropriately sanitized packing materials at the premise from which the export 

process began.

**********************Certificate shall be valid for 30 days from date of issue************************

If the issuing veterinarian is the same as the official veterinarian, only 1 signature and stamp is required.

Name of Issuing Veterinarian (Printed) Name of Official Veterinarian (Printed) 

Signature of Issuing Veterinarian Signature of Official Veterinarian

Date Date