Animal Blastomycosis Case Report Form - Minnesota Dept. of Health. Animal Blastomycosis Case report form to submit to Minnesota Dept. of Health. 2026

1. Click ‘Get Form’ to open the Animal Blastomycosis Case Report Form in our editor.
2. Begin by filling out the Demographic Information section. Enter the owner's name, address, city, zip code, phone numbers, email, and veterinary clinic details.
3. In the Pet Information section, provide the pet's name, species, date of birth, sex, spayed/neutered status, and whether the pet is primarily indoors or outdoors.
4. List any symptoms observed in your pet by checking the appropriate boxes. Indicate if the pet has been hospitalized for blastomycosis and detail any treatments received.
5. Complete the Diagnostic Information section by entering lab names and collection dates for various tests conducted on your pet.
6. Fill in Clinical Illness History with illness onset and first appointment dates. Provide weight and breed information as well.
7. Finally, summarize the case by indicating the type of blastomycosis and marking all affected locations if applicable.

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