Homepage Fillable Rabies Certificate Template

File Details

Fact Name Description
Form Title The form is officially titled "Rabies Vaccination Certificate" and is recognized as NASPHV FORM 51 (revised 2007).
Owner Information Pet owners must provide their name, address, and telephone number clearly on the form.
Animal Identification The form requires details about the animal, including species, age, size, and predominant breed.
Vaccination Details It includes information on the vaccination date, product name, and the veterinarian's name and license number.
Rabies Tag Number A unique rabies tag number must be included, which helps in tracking the vaccination status.
Duration of Vaccination The certificate can indicate different vaccination durations, such as 1 year, 3 years, or 4 years.
State-Specific Requirements Each state may have specific laws governing rabies vaccinations and the use of this certificate.

Sample - Rabies Certificate Form

 

 

 

RABIES VACCINATION CERTIFICATE

 

 

Push to Print Form

 

Push to Reset Form

 

 

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

Completing the Rabies Certificate form accurately is crucial for pet owners. However, many make common mistakes that can lead to complications. One frequent error occurs when individuals fail to print clearly in the designated areas. Illegible handwriting can result in important information being misunderstood or overlooked.

Another mistake is neglecting to include the microchip number. This detail is essential for identifying the pet if it goes missing. Without it, recovery efforts can become more challenging. Additionally, some pet owners forget to specify the predominant breed of their animal. This information helps veterinarians and animal control officers understand the pet's characteristics better.

Many people also overlook the importance of providing accurate owner contact information. The telephone number should be current and easy to read. If there is an emergency, having the correct contact information can make all the difference in ensuring the pet's safety.

Another common issue is the selection of the vaccination duration. Owners often select the wrong duration for the rabies vaccination, whether it be 1 year or 3 years. Misunderstanding this can lead to lapses in the pet's vaccination status, which can have serious health implications.

In some cases, individuals forget to include the veterinarian's name and license number. This information is vital for validating the vaccination and ensuring that it was administered by a qualified professional. Additionally, the vaccine serial number is often left blank. This number is important for tracking and safety purposes.

Another mistake involves the date of vaccination. Some pet owners may inadvertently write the wrong date or fail to provide a date at all. This can create confusion regarding the pet's vaccination timeline and may lead to compliance issues.

Finally, individuals sometimes neglect to have the form signed by the veterinarian. A signature is a critical component of the certificate, as it verifies that the vaccination was administered properly. Without it, the certificate may not be accepted by authorities or pet boarding facilities.

By being aware of these common mistakes, pet owners can ensure that their Rabies Certificate form is filled out correctly. This attention to detail helps protect not only their pets but also public health.