Get Ca Tick-borne Disease Reporting Form - Los Angeles County 2015

This guide provides clear and supportive instructions for completing the CA Tick-Borne Disease Reporting Form online. By following these steps, users can ensure accurate and efficient reporting of tick-borne diseases in pets within Los Angeles County.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by selecting the disease relevant to your pet. Check the appropriate box for either Anaplasmosis, Borreliosis (Lyme), Babesiosis, Ehrlichiosis, or Spotted Fever Rickettsiosis (Rocky Mountain Spotted Fever).
3. Provide details regarding the pet. Include the pet's name, breed, sex/neuter status, and age.
4. Fill out the pet owner's information. Enter the name(s), address, city, ZIP code, and telephone number. Indicate whether the owner can be contacted for further questions about the pet's history by checking 'Yes' or 'No'.
5. Complete the reporting facility section. Input the veterinarian or technician's name, clinic or shelter's name, address, city, ZIP code, telephone number, fax number, and email.
6. In the tick exposure history, specify if ticks from the pet have been saved in alcohol and whether the owner has seen ticks on the pet. List the parks and locations in Los Angeles County that the pet visits, and indicate if the pet has visited places outside of LA County, including where.
7. Document clinical findings, including the date of onset, date of presentation, and date of death if applicable. Measure and record the highest body temperature, and check all relevant symptoms such as fever, anorexia, vomiting, and any other clinical signs observed.
8. In the treatments section, list any treatments administered, such as antibiotics, corticosteroids, or ectoparasite control.
9. Compile all laboratory results and prepare to fax them along with this form to the specified fax number (213-481-2375).
10. Review the completed form carefully. Save changes, then proceed to download, print, or share the form as necessary.

Complete your CA Tick-Borne Disease Reporting Form online today to ensure your pet receives the appropriate care.