Get the free Heartworm Report Form - Los Angeles County California

VETERINARY PUBLIC HEALTHGRADES CONTROL PROGRAM Tel. (213) 9897060 or (877) 7472243 Fax (213) 4812375 publichealth.lacounty.gov/vet Heartworm Report Form Date form completed 1. Pet Dog Cat Name Breed

How to fill out heartworm report form

How to fill out heartworm report form:

1. Start by entering your personal information, such as your name, address, and contact information.
2. Next, provide information about your pet, including their name, breed, age, and gender.
3. Indicate the heartworm prevention method used for your pet, whether it's a monthly chewable, topical treatment, or injectable.
4. Specify the dates when your pet was tested for heartworm and the results of the tests.
5. If your pet tested positive for heartworm, provide details about the treatment administered, including the medication used and the duration of treatment.
6. If your pet tested negative, indicate the preventive measures taken to ensure their continued heartworm-free status.
7. Include any additional information or comments regarding your pet's heartworm history or treatment, if necessary.
8. Finally, sign and date the form to certify the accuracy of the information provided.

Who needs heartworm report form:

1. Veterinarians: The heartworm report form is essential for veterinarians to keep track of their patients' heartworm prevention history and treatment.
2. Pet owners: It is beneficial for pet owners to fill out the heartworm report form to provide comprehensive information about their pet's heartworm status, which can be useful for future reference or when changing veterinarians.
3. Animal shelters and rescue organizations: These organizations may require heartworm report forms to ensure the health and safety of the animals they house and adopt out.

Overall, anyone involved in the care and treatment of pets, including veterinarians, pet owners, and animal shelters, can benefit from utilizing the heartworm report form to maintain accurate records and ensure the well-being of the animals.

For pdfFiller’s FAQs

What is heartworm report form?

The heartworm report form is a document used to report cases of heartworm disease in animals.

Who is required to file heartworm report form?

Veterinarians and animal healthcare professionals are required to file the heartworm report form.

How to fill out heartworm report form?

To fill out the heartworm report form, provide information about the animal, test results, treatment, and any other relevant details.

What is the purpose of heartworm report form?

The purpose of the heartworm report form is to track and monitor cases of heartworm disease in animals for public health and research purposes.

What information must be reported on heartworm report form?

Information such as animal's name, age, breed, test results, treatment, and contact information must be reported on the heartworm report form.

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