Get Ca Tick-borne Disease Reporting Form - Los Angeles County 2021-2026

Filling out the CA Tick-Borne Disease Reporting Form is an essential step in reporting pet illnesses related to tick-borne diseases. This guide provides clear, step-by-step instructions to help users accurately complete the form online.

Follow the steps to successfully complete the reporting form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. In the first section, indicate the specific tick-borne disease by checking the appropriate box next to the disease your pet has been diagnosed with, such as Anaplasmosis or Borreliosis (Lyme).
3. For the pet details, enter the name, breed, sex/neutering status, and age of your pet. Select the type of pet by checking the corresponding box for Dog, Cat, or Other.
4. Input the pet owner's information by providing the name(s), address, city, ZIP code, and telephone number. Indicate whether it is permissible to contact the owner(s) for additional history by selecting 'Yes' or 'No.'
5. In the Reporting Facility section, fill in the name of the veterinarian or technician, the clinic or shelter name, their address, city, ZIP code, and telephone number. Additionally, provide the fax number and email address of the facility.
6. Document the tick exposure history by indicating whether ticks from the pet have been saved in alcohol for identification, and if the owner has observed ticks on the pet previously. List parks and places in Los Angeles County that the pet has visited, and indicate if the pet has visited locations outside of LA County.
7. Fill out the clinical findings by entering the date of onset, date of presentation, and date of death (if applicable). Include the highest body temperature measured and check all relevant clinical signs that have been observed, such as fever or vomiting.
8. In the treatment section, describe any treatments that the pet has received, including medications or therapies such as antibiotics or corticosteroids.
9. In the laboratory results section, note that all relevant lab results must be faxed along with this form to ensure comprehensive reporting.
10. After completing the form, you can save your changes, download a copy for your records, print the form for physical submission, or share it via email as required.

Complete the CA Tick-Borne Disease Reporting Form online now to ensure your pet receives the necessary attention and care.