Department of Public Health
   
ANIMAL DISEASE PUBLIC SHORT REPORT FORM   (*Required Fields)

Animal disease reports are essential for identifying outbreaks, disease trends, and new diseases. This information is used to educate veterinarians, physicians, and others to help protect the health of animals and people. REPORTING SICK OR DEAD BIRDS for possible AVIAN INFLUENZA TESTING, as of 1/24/2024: Report the bird to your local animal control agency. They might be able to collect and hold it for HPAI testing. Waterfowl, shorebirds and medium or large birds are the best types of birds to test for HPAI. Please also complete this reporting form below to notify us. Be sure to include information on how to contact you, and let us know if Animal Control is planning to collect the bird. Never touch a sick or dead bird without wearing personal protective equipment. Learn more at ph.lacounty.gov/vet/HPAI.htm

Animal's Information
 
# of Animals * Name of Species Breed Date Animal Found Color
 

Animal's Location Information (if different from owner's residence)
  
Numeric Address:      * Street Name or Street Intersection:  

* City:      Add New City Here:

   Zip:    
Telephone                                  Alternate Contact (phone, email, etc.)
(555-555-5555)   
Comments:


 

Reporter Information
 
* Last Name            * First Name      

* Numeric Address          * Street Name              

* City                                  

Add New City Here              Zip    
*Alternate Contact (phone, email, etc.)
(555-555-5555)     
 

Animal Owner's Information (if applicable)
 
Same as Reporter Information
Last Name            First Name      
Numeric Address         Street Name              

City                Add New City Here           Zip         

Telephone     
Alternate Contact (phone, email, etc.) (555-555-5555)     

   

 
Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
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