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LCHD Tick Identification Form

Reporting Information

1. Contact Information *This question is required.
We will use this information to follow-up with you regarding your submission.
 

Note: Date is collected in mm/dd/yyyy format.
  This question requires a valid date format of MM/DD/YYYY.
calendar
3. Where was the tick found? *This question is required.
4. If the tick was found on a person, was the tick attached?
4. How long do you think the tick was attached? (Number can be approximate)
This question requires a valid number format.
4. Was the tick engorged? An engorged tick will be ballooned in size as shown below.
5. Where do you think the tick exposure occurred? *This question is required.
6. Provide the address where the tick exposure most likely occurred. (Provide as much information as you have available)
7. If you have a photo, please upload it by clicking the "Browse" button below. (See the examples of good and bad photo submissions)
  • In a well-lit room, place the tick on a plain white or light colored surface.
  • Focus the camera as close as possible to the tick; it is important that the picture is not blurry.

  
 
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