ADA444.

1121
September 2023

Animal care declaration

Section A: General information

Purpose of this All animals who are required to isolate at the Post-Entry Quarantine facility must
declaration complete the Animal Care declaration. This declaration must be completed and
signed by:
• the person in charge of the animal (importer, as listed on the import
permit) and
• the government-approved veterinarian preparing the animal for import
into Australia.

SECTION B - D • Must be completed by the person in charge for each animal undergoing
post-entry quarantine.
SECTION E - G • Only required if the animal has a medical condition or requires
medication during their quarantine period. These sections must be
completed by the government approved veterinarian.

Before completing Ensure that you understand your responsibilities as the:

this declaration • person in charge of the animal
• government-approved veterinarian.
Read Cats and dogs travelling to Australia with special care requirements and the
relevant step-by-step guide for importing cats and dogs into Australia.

To complete this Electronically

declaration You need the latest version of Adobe Acrobat Reader to save changes to this form on
your computer or device. Download the Adobe Acrobat Reader mobile app for your
smartphone or tablet.
Electronic or digital signatures will be accepted.

Manually
Use black or blue pen
Print in BLOCK LETTERS
Scan the document

To submit the The importer must upload the completed form to the animal’s Post Entry Biosecurity
declaration System reservation.
Ensure that the information contained in this declaration is current at the time of
the animal’s arrival in Australia.

For any queries regarding this form, please contact post-entry quarantine at
PEQservices@aff.gov.au

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 Form identification number ADA444.1121

Section B: Person in charge of the animal (importer)

1 Importer
Title Given name Family name

Email Australian phone number

2 Have you asked an authorised agent to act on your behalf while your animal is in Australian post-entry quarantine?
No

Yes

3 Australian emergency contact details for importer or nominated authorised agent (if same as question 1,
insert AS ABOVE)
Contact details must be valid for the entire post-entry quarantine isolation period. These details will be used in the
event of a veterinary emergency.
Title Given name(s) Family name

Email Australian phone number

Section C: Animal details

To be completed by the importer named in section B.

4 Species (dog or cat)

5 Name of animal

Age (in years/months)

Breed

8 Weight or normal weight range

Will the animal be pregnant at the time of import into Australia?

No

Yes

10 Microchip number (Must be 9, 10 or 15 digits, ISO compatible and not start with the prefix ‘999’)

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 Form identification number ADA444.1121

Import permit number

12 What is your animal's behaviour with new people and a new environment?
Friendly
Anxious
Scared/Stressed
Prefer females / males (please circle)

Is there anything we should know about your animals behaviour? Please include information about formal
training and/or general temperament.

The Post Entry Quarantine facility provides a premium branded dry and wet food to all animals.
13 Does this animal require a special diet?

No Go to question 15

Yes Go to question 14

14 Details of special diet

It is the importer’s responsibility to supply any special diets at least 2 weeks before the animal arrives at the post-
entry quarantine facility.

Pet food must be sourced from Australia. For delivery instructions, see Special diets.

List the type of diet and quantities to be fed:

Food name Quantity/Frequency Reason for diet (e.g. allergies)

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15 Do you consent to the use of Nutrigel/Nutripet or Energel if required, to stimulate eating after arrival
at Post Entry Quarantine?
No

Yes

Section D: Declaration of person in charge of the animal

To be completed by the importer named in section B.
I declare that the information I have provided is true and correct. I understand that it is a criminal offence under the Criminal
Code Act 1995 to knowingly give false or misleading information to a Commonwealth officer exercising powers under
Commonwealth law. This offence carries a maximum penalty of 12 months’ imprisonment.
If I have nominated an authorised agent in section B, I declare that I have given them permission to:
• receive information about the animal identified in section C
• authorise private veterinary treatment if required.
I have informed the authorised agent about their responsibilities and functions. I understand that I am responsible for all costs
associated with private veterinary treatment.
I have read and understood the privacy notice and Privacy Policy.

Signature (type or sign your name) Date (dd/mm/yyyy)

Full name

SECTION E, F & G IS ONLY TO BE COMPLETED IF YOUR

ANIMAL HAS A MEDICAL CONDITION OR REQUIRES
MEDICATION WHILST IN QUARANTINE.

IF THIS DOES NOT APPLY TO YOUR ANIMAL, END THE FORM HERE.

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Section E: Government-approved veterinarian

To be completed by the government-approved veterinarian preparing the animal for import into Australia.

16 Government-approved veterinarian
Title Given name(s) Family name

Email

17 Name of veterinary practice

18 Address of veterinary practice

Street address State/territory Postcode

Suburb/town/city Email

Country

Section F: Medication and/or special care requirements

To be completed by the government-approved veterinarian listed in section E.
19 Will the animal named in section C require medication during the quarantine period?

No Go to question 22

Yes Go to question 20

20 Does this animal’s medication dosing schedule fall between the daytime hours of 08:00 and 16:00?
No If the animal’s medication dosing schedule cannot be accommodated within these hours,
its special care requirements cannot be met in quarantine.

Yes Go to question 21

21 List current medications (attach more pages if necessary)

Unless an import permit is provided for the medication, all medications and/or veterinary therapeutics
from overseas will be destroyed on completion of the animal’s quarantine period.
Diagnosis Medication (active ingredient and Dose Route of administration Frequency
product name)

Example: Epilepsy Phenomav (Phenobarbitone) 100mg 1 tablet twice Oral AM & PM

daily

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22 Further information regarding medical condition (if required)

Section G: Declaration of government-approved veterinarian

To be completed by the government-approved veterinarian named in section E.
I declare that:
• I have read and considered the general advice provided on the Cats and dogs travelling to Australia with special care
requirements web page.
• I have examined the animal identified in section C of this form, reviewed the animal’s medical history and considered all
relevant risks relating to the animal’s conditions and health status in the context of international travel and quarantine.
• I have discussed the relevant risks with the person in charge of the animal, and the person in charge understands the
risks. I have read and understood the privacy notice and Privacy Policy.
Signature (type or sign your name) Date (dd/mm/yyyy)

Full Name

Section H: Privacy notice

‘Personal information’ means information or an opinion about an identified individual, or an individual who is reasonably
identifiable. ‘Sensitive information’ is a subset of personal information and includes any information or opinion about an
individual’s racial or ethnic origin, political opinion or association, religious beliefs or affiliations, philosophical beliefs, sexual
preference or practices, trade or professional associations and memberships, union membership, criminal record, health or
genetic information and biometric information or templates.
Personal information is collected under the Biosecurity Act 2015 is defined as ‘protected information’.
By completing and submitting this form you consent to the collection of all protected information contained in this form.
The Department of Agriculture, Water and the Environment collects protected information, including personal and sensitive
information, in relation to this declaration as required under the Biosecurity Act for the purposes of dealing with an application
to bring or import goods into Australia and related purposes.
The department may disclose the protected information requested in this form to Australian, state or territory government
agencies, or other persons or organisations where necessary for the purposes described, provided the disclosure is consistent
with relevant laws, particularly the Biosecurity Act and the Privacy Act 1988.
Protected information collected by the department will only be used or disclosed as authorised under the Biosecurity Act and
the Privacy Act. The protected information in this form will be used and stored in accordance with Australian Privacy Principles.
See the department’s Privacy Policy to learn more about accessing or correcting personal information or making a complaint.
Alternatively, telephone the department on +61 2 6272 3933.

SAVE PRINT CLEAR

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