Tick-borne Disease Reporting Form for Animals in Los Angeles County 2026

1. Click ‘Get Form’ to open the Tick-borne Disease Reporting Form in our editor.
2. Begin by filling out the date the form is completed at the top of the document.
3. In section 1, select the disease affecting your pet by checking the appropriate box for Anaplasmosis, Borreliosis (Lyme), Babesiosis, Ehrlichiosis, or Spotted Fever Rickettsiosis.
4. Section 2 requires you to provide details about your pet. Fill in their name, breed, sex/neutering status, and age.
5. In section 3, enter your name as the pet owner along with your address, city, ZIP code, and telephone number. Indicate if we may call you for more information.
6. For section 4, provide details about the reporting facility including veterinarian or technician's name and clinic/shelter information.
7. In section 5, answer questions regarding tick exposure history and list parks or places in LA County that your pet visits.
8. Section 6 asks for clinical findings; fill in dates of onset and presentation along with any observed symptoms by checking applicable boxes.
9. Document any treatments administered in section 7 and ensure to fax all laboratory results along with this form as indicated at the bottom.

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