Health Certificate Information Owner's Name? Horse(s) name? Owner's Phone? Email where certificate(s) will be sent? Address of horses(s) origin? Purpose of Move? Shipping Date? Address of Destination? Name of Contact at Destination? Contact at Destination Phone Number? Who is Transporting? Address of Transporter? Phone of Transporter? Does you horse have a current Coggins? (Completed within a year) Does you horse have a current Coggins? (Completed within a year) YesNo Date of Coggins? Additional Directions or Comments? 14 + 10 = Submit
