Pet Owner Reporting Form:

County of Los Angeles 
Department of Public Health 
Veterinary Public Health Program

We are seeking to better understand any unintended negative effects pets may have when exposed to cannabis and cannabis-related products.

As cannabis and cannabis products become increasingly available, tracking your pet's reaction to cannabis may be important in helping us reduce the risks of your pets getting sick from these products.

We are asking pet owners who have animals that have experienced negative reactions from exposure to cannabis or cannabis products, to report to us by completing this short survey.

Your participation in this survey is voluntary and anonymous.

Thank you for providing valuable information to help us improve animal and human health in Los Angeles County. 

 

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* 1. What is your zip code?

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* 2. What kind of pet experienced an adverse reaction to cannabis?

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* 3. What is your pet's approximate age in years?

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* 4. What is the approximate weight of your pet in pounds?

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* 5. What type of cannabis product was your pet exposed to? 

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* 6. Please identify the brand name(s) of the cannabis product(s) that led to an adverse reaction in your pet.

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* 7. Was the product for humans or pets? 

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* 8. Did your pet get exposed to cannabis accidentally? 

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* 9. If you gave your pet a cannabis product for medicinal purposes, how often was it given? (Ex: 1 chew given three times a day for 3 weeks)

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* 10. Does the packet list how much CBD or THC is in the product? If so, please provide below.

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* 11. Where did you get the cannabis or cannabis product from?

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* 12. On what approximate date did your pet become ill?

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* 13. What symptoms did your pet show after exposure to cannabis? (ex: sedation, vomiting, incoordination, etc.)

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* 14. Was your pet taken to a veterinarian for cannabis toxicity?

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* 15. What was the approximate cost of veterinary care for this incident of cannabis toxicity?

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* 16. Was your pet hospitalized for treatment of cannabis toxicity?

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