H EALTH C ERTIFICATE I NFORMATION Who is showing? ▪ Name:__________________________________________________ ▪ Address:________________________________________________ ▪ Phone Number: _________________________________________ ▪ Email address: __________________________________________ Where are the animal(s) going? ▪ Location name: _________________________________________ ▪ Address: _______________________________________________ ▪ Phone number: _________________________________________ Animal information: ▪ Species: _______________________________________________ ▪ Name: _________________________________________________ ▪ Breed: _________________________________________________ ▪ Color(s): _______________________________________________ ▪ Birthdate: ______________________________________________ ▪ ID number: _____________________________________________ (I.e. RFID, Scrapies, Tattoo, metal tag, ear notch, etc.) Invoicing: ▪ Client Account: _________________________________________ ▪ Phone Number: _________________________________________ **Please make sure all information is correct**