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RABIES VACCINATION CERTIFICATE

 

 

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NASPHV FORM 51 (revised 2007)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RABIES TAG #

 

 

 

 

 

 

 

 

Owner's Name & Address

Print Clearly

MICROCHIP #

 

 

 

 

 

LAST

FIRST

M.I.

TELEPHONE #

 

NO.STREET

CITY

STATE

ZIP

SPECIES

AGE

 

 

 

 

 

 

 

 

SIZE

PREDOMINANT BREED

PREDOMINANT

Dog

 

 

 

 

 

 

 

 

 

 

Months

Under 20 lbs.

 

 

 

 

 

 

 

 

COLORS/MARKINGS

Cat

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Years

 

 

20 - 50 lbs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ferret

 

 

 

 

SEX

 

 

Male

Over 50 lbs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Female

 

 

 

 

 

 

 

 

 

 

ANIMAL NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Neutered

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Animal Control License

 

 

 

 

 

1 Yr

 

 

 

3 Yr

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE VACCINATED

Product Name:

 

 

 

 

 

 

 

 

 

 

Veterinarian's Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Manufacturer:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month / Day / Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

License Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

(First 3 letters)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 Yr USDA Licensed Vaccine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEXT VACCINATION

 

 

 

 

 

3 Yr USDA Licensed Vaccine

 

 

 

Veterinarian's Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DUE BY:

 

 

 

 

 

4 Yr USDA Licensed Vaccine

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initial dose

 

 

Booster dose

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month / Day / Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vaccine Serial (lot) Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common mistakes

Filling out the Rabies Certificate form can be straightforward, but several common mistakes can lead to delays or complications. One frequent error is failing to print clearly. Illegible handwriting can result in miscommunication, especially regarding critical information like the owner’s name or the animal’s details.

Another mistake is not including the correct microchip number. If the animal is microchipped, this number is essential for identification. Leaving it blank can hinder the tracking of the pet in case it goes missing.

Many people also overlook the animal’s breed. Specifying the predominant breed is crucial for accurate record-keeping. Incomplete breed information can lead to issues with licensing and vaccinations in the future.

Some individuals forget to indicate the animal’s sex. This detail is important for vaccination records and may affect future health considerations. Always double-check that this information is included.

Another common error involves the vaccination dates. It’s vital to accurately fill in the date of vaccination and ensure it matches the veterinarian’s records. Incorrect dates can lead to confusion about when the next vaccination is due.

People often neglect to provide the veterinarian's license number. This number verifies that the vaccination was administered by a qualified professional. Omitting it can invalidate the certificate.

Additionally, some forms are submitted without the veterinarian’s signature. A signature is necessary to confirm that the vaccination was performed and to make the certificate official.

Another mistake is not specifying the vaccine type. Indicating whether it’s a one-year or three-year vaccine is essential for compliance with local laws and regulations.

Lastly, individuals may forget to check the animal control license status. Ensuring that this information is accurate helps avoid potential fines or legal issues down the line.

By avoiding these common mistakes, you can ensure that the Rabies Certificate form is filled out correctly and efficiently, making the process smoother for everyone involved.

Dos and Don'ts

When filling out the Rabies Certificate form, it’s important to ensure that the information is accurate and complete. Here are some guidelines to follow:

  • Do: Print clearly in all sections to avoid any misunderstandings.
  • Do: Double-check the animal's details, including species, age, and breed.
  • Don't: Leave any required fields blank; this can delay the process.
  • Don't: Use abbreviations or unclear terms that might confuse the reader.

Similar forms

  • Vaccination Certificate: Similar to the Rabies Certificate, this document confirms that an animal has received vaccinations against various diseases. It includes details such as the type of vaccine, date administered, and veterinarian information.

  • Health Certificate: This document verifies that an animal is healthy and free from contagious diseases. It is often required for travel or boarding and includes a veterinarian's assessment.

  • Microchip Registration Form: This form documents the registration of an animal's microchip. It includes the owner's information and the unique ID number of the microchip, similar to how the Rabies Certificate includes identification details.

  • Non-disclosure Agreement: This document protects sensitive business information and maintains confidentiality between parties, similar to the importance of safeguarding pet vaccination details, as found in the smarttemplates.net.
  • Animal Control License: This license indicates that an animal is registered with local authorities. It often requires proof of vaccinations, including rabies, paralleling the Rabies Certificate's purpose.

  • Pet Insurance Policy: This document outlines the coverage for veterinary services, including vaccinations. It may reference the Rabies Certificate as part of the required documentation for claims.

  • Travel Health Certificate: Required for pets traveling internationally, this document verifies that the animal is up-to-date on vaccinations, including rabies, similar to the Rabies Certificate.

  • Breeder's Certificate: This document provides proof of an animal's lineage and health status. It may include vaccination records, including rabies, akin to the Rabies Certificate.

  • Adoption Agreement: When adopting a pet, this document often includes health and vaccination information. It may reference the Rabies Certificate as part of the animal's health history.