Get the free IMMUNIZATION HISTORY & TB SKIN TEST FORM - ohsu
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This form is required for volunteers at OHSU to document their immunization history and TB skin test results before they begin their volunteer positions.
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How to fill out immunization history tb skin
How to fill out IMMUNIZATION HISTORY & TB SKIN TEST FORM
01
Obtain the IMMUNIZATION HISTORY & TB SKIN TEST FORM from your healthcare provider or institution.
02
Fill in your personal information at the top of the form, including your name, date of birth, and contact details.
03
In the immunization history section, list all vaccinations you have received, including dates and types of vaccines.
04
Ensure accuracy by cross-referencing with your vaccination records or medical history.
05
In the TB skin test section, indicate whether you have had a TB test done, and provide the date and result if applicable.
06
If required, have your healthcare provider sign or verify the information on the form.
07
Review the form for completeness and accuracy before submission.
08
Submit the completed form to the appropriate authority or institution as instructed.
Who needs IMMUNIZATION HISTORY & TB SKIN TEST FORM?
01
Individuals applying for certain jobs, schools, or programs that require proof of immunization and a TB skin test.
02
Healthcare workers or students in healthcare-related fields who need to demonstrate their immunization status.
03
Travelers going to specific destinations that require immunization records.
04
Individuals undergoing specific medical procedures that necessitate an updated immunization history.
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People Also Ask about
How to fill out the AAMC standardized immunization form?
How to fill out the AAMC Standardized Immunization Form for Students? Prepare all necessary vaccination records. Fill in your personal information accurately. Indicate the immunizations you have received. Ensure to attach any required documentation. Review the form for completeness before submission.
How to fill out an AAMC immunization form?
How to fill out the AAMC Standardized Immunization Form for Students? Prepare all necessary vaccination records. Fill in your personal information accurately. Indicate the immunizations you have received. Ensure to attach any required documentation. Review the form for completeness before submission.
How do you document a TB skin test?
TST Documentation Requirements Name and signature of person administering test. Date and time test administered. Location of test (e.g., right forearm, left forearm, alternate site) Tuberculin manufacturer, lot number and expiration date.
What is the full form of TB skin test?
A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is also called an Interferon-Gamma Release Assay (IGRA). TB skin tests are more common and are the preferred type for children under age 5.
How to write TB skin test results?
* Record the exact measurement in millimeters of induration on the Mantoux Tuberculin Skin Test Record Form. Do not record the interpretation of the results as “positive” or “negative.” Note: If doing two-step testing, explain to patient the reason for doing so prior to administering the skin test.
How to get an immunization form filled out?
Ask your doctor, pharmacist or other vaccine provider for an immunization record form or download and use this form [4 pages]. Bring this record with you to health visits, and ask your vaccine provider to sign and date the form for each vaccine you receive.
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What is IMMUNIZATION HISTORY & TB SKIN TEST FORM?
The IMMUNIZATION HISTORY & TB SKIN TEST FORM is a document that records an individual's vaccination history and the results of their tuberculosis skin test.
Who is required to file IMMUNIZATION HISTORY & TB SKIN TEST FORM?
Individuals, especially students, healthcare workers, and those in certain employment or educational programs, are typically required to file the IMMUNIZATION HISTORY & TB SKIN TEST FORM.
How to fill out IMMUNIZATION HISTORY & TB SKIN TEST FORM?
To fill out the form, provide personal information including name, date of birth, and contact information. Document all vaccinations received, dates, and the results of the TB skin test, including the date administered and read.
What is the purpose of IMMUNIZATION HISTORY & TB SKIN TEST FORM?
The purpose of the form is to ensure individuals are up-to-date with their vaccinations and to screen for tuberculosis exposure, to prevent outbreaks in communities.
What information must be reported on IMMUNIZATION HISTORY & TB SKIN TEST FORM?
The form must report the individual's full name, date of birth, vaccination dates, types of vaccines received, TB skin test details including the date given, date read, results, and any relevant medical history.
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