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Microchip Implant Certificate

By Dr Duncan Houston

A free fillable microchip implantation certificate for veterinary use. Record the chip, certify the implant, sign on screen, then print or download as a PDF. Nothing you enter is stored or sent anywhere.

Clinic Details

Owner's Details

Animal's Details

Microchip Details

Implanting a microchip does not register it. The microchip must be registered with a licensed registry, and the owner's contact details kept up to date, for the animal to be identifiable if lost. A microchip with outdated contact details cannot reunite you with your animal.

Implanter Certification

I certify that I implanted the microchip with the number recorded above into the animal described on this form on the date shown, and that I scanned the microchip after implantation and confirmed that it reads correctly.
Implanter signature
Clinic stamp (stamp the printed copy)
Built by Dr Duncan Houston for ASK A VET™ · askavet.com
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Nothing typed into this form is sent to or stored by askavet.com. All data stays in your browser and leaves only in the PDF or printout you create. Microchipping and registration rules differ by state and country, including who may implant. Check your local requirements before use.