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City of Long Beach Department of Health and Human Services 2525 Grand Avenue, Suite 201 Long Beach, California 90815 Phone: (562) 5704241 Fax: (562) 5704013Heartworm Report Form Pet Information: Animal
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How to fill out heartworm report form
How to fill out heartworm report form
01
To fill out the heartworm report form, follow these steps:
02
Start by entering the patient's information on the top section of the form, including their name, age, breed, and owner's contact details.
03
Indicate the date of the heartworm test and the test method used.
04
Record the results of the heartworm test, including the presence or absence of heartworm infection.
05
If the patient is positive for heartworms, note the severity of the infection and any accompanying symptoms.
06
Document the prescribed treatment plan, including medication dosage, duration, and any additional instructions.
07
Provide any relevant information regarding the patient's medical history, such as previous heartworm treatments or preventive measures.
08
Finally, make sure to sign and date the form before submitting it to the appropriate authority or retaining it for record-keeping purposes.
Who needs heartworm report form?
01
The heartworm report form is typically needed by veterinarians, animal shelters, and pet owners to document a dog's heartworm status, test results, and treatment plans.
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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 owners are required to file the heartworm report form.
How to fill out heartworm report form?
The heartworm report form can be filled out by providing information such as the animal's name, breed, age, test results, and treatment history.
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.
What information must be reported on heartworm report form?
Information that must be reported on the heartworm report form includes the animal's identification, test results, treatment history, and contact information.
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