Get the free Tuberculosis (TB) Screening Questionnaire - colgate

A screening questionnaire for incoming students at Colgate University to assess their risk of tuberculosis exposure.

How to fill out tuberculosis tb screening questionnaire

How to fill out Tuberculosis (TB) Screening Questionnaire

1. Begin with personal information: Write your full name, date of birth, and contact information.
2. Answer questions about your medical history: Indicate if you have ever had TB or a positive TB test.
3. Provide information on current symptoms: Check yes or no if you have a persistent cough, weight loss, night sweats, or fever.
4. List any recent travel: Indicate if you have traveled to areas with high TB rates in the past year.
5. Include any exposure: Report if you have been in close contact with someone who has active TB.
6. Complete additional sections: Fill out any other required questions regarding risky behaviors or health conditions.
7. Review your answers: Double-check all information for accuracy before submission.
8. Submit the questionnaire: Follow instructions for how to return or submit the form to the appropriate health authority.

Who needs Tuberculosis (TB) Screening Questionnaire?

1. Individuals who have symptoms of TB, such as a persistent cough or unexplained weight loss.
2. People who have been in close contact with someone diagnosed with active TB.
3. Those who have traveled to countries with high incidences of TB.
4. Individuals with weakened immune systems or specific health conditions that increase the risk of TB.

People Also Ask about

What questions to ask about TB?

Frequently Asked Questions (FAQs) What is tuberculosis? What is the difference between TB infection and TB disease? Who can get TB? What are the symptoms of TB? Who should be tested for TB? How can TB be tested for? What is the treatment for TB? What if I have HIV?

What are TB questions?

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis (M. tuberculosis). The bacteria, or germs, usually affect the lungs. TB germs can affect any part of the body, such as the kidneys, spine, or brain.

What questions should I ask about TB?

Frequently Asked Questions (FAQs) What is tuberculosis? What is the difference between TB infection and TB disease? Who can get TB? What are the symptoms of TB? Who should be tested for TB? How can TB be tested for? What is the treatment for TB? What if I have HIV?

What questions do they ask for TB screening?

Tuberculosis Risk Assessment Have you had a cough lasting more than three weeks? Have you lived with or spent time with anyone who had or may have had TB? Have you lived in or visited any of the following areas for more than a month: Africa, Asia, Mexico, Central or South America, the Caribbean or Eastern Europe?

What questions should I ask for TB exposure?

Tuberculosis Risk Assessment Have you had a cough lasting more than three weeks? Have you lived with or spent time with anyone who had or may have had TB? Have you lived in or visited any of the following areas for more than a month: Africa, Asia, Mexico, Central or South America, the Caribbean or Eastern Europe?

What is the English test for TB?

A TB test checks to see if you've been infected with tuberculosis (TB). There are two types of TB tests: a skin test and a blood test. TB skin and blood tests can show if you've ever been exposed to the bacterium that causes TB, but they can't determine if you have a latent (dormant) or active TB infection.

What is the screening test for tuberculosis?

You will have either be a TB skin test or a TB blood test, depending on your health and medical history. TB skin tests are used more often, but blood tests for TB are becoming more common. For a TB skin test (also called a Mantoux tuberculin skin test), you will need two visits to complete the test.

What are TB screening questions?

Have you ever had a positive TB skin test? Have you ever been vaccinated with BCG? Have you ever had close contact with persons known or suspected to have active TB disease?

For pdfFiller’s FAQs

What is Tuberculosis (TB) Screening Questionnaire?

The Tuberculosis (TB) Screening Questionnaire is a tool used to assess an individual's risk of having or being exposed to tuberculosis. It typically includes a series of questions designed to identify symptoms, exposure history, and potential risk factors related to TB.

Who is required to file Tuberculosis (TB) Screening Questionnaire?

Individuals who are at risk of tuberculosis exposure, such as healthcare workers, immigrants from high-prevalence countries, and those entering certain educational programs or employment in healthcare or congregate settings, are typically required to file the TB Screening Questionnaire.

How to fill out Tuberculosis (TB) Screening Questionnaire?

To fill out the Tuberculosis (TB) Screening Questionnaire, individuals should answer all questions honestly and to the best of their ability. This includes providing information about symptoms, travel history, contact with TB patients, and any prior TB testing or treatment.

What is the purpose of Tuberculosis (TB) Screening Questionnaire?

The purpose of the Tuberculosis (TB) Screening Questionnaire is to identify individuals who may be at risk for TB infection or disease. It helps healthcare providers determine the need for further evaluation, testing, or preventive treatment to control the spread of TB.

What information must be reported on Tuberculosis (TB) Screening Questionnaire?

The Tuberculosis (TB) Screening Questionnaire typically requires reporting on symptoms such as cough, fever, night sweats, weight loss, exposure to TB, prior TB history, and vaccination status. Accurate reporting is crucial for assessing TB risk.