Get the free Tuberculosis (TB) Screening Form - Rowan University - rowan

Tuberculosis (TB) Screening Form Student Name Rowan ID # YES NO Have you ever had a positive tuberculosis skin test or blood test? Have you ever had close contact with anyone who was sick with TB?

How to fill out tuberculosis tb screening form

How to fill out tuberculosis TB screening form:

1. Start by providing your personal information such as your full name, date of birth, and contact details.
2. Indicate your gender and ethnicity on the form.
3. Specify your current address and any previous addresses if applicable.
4. Provide information about your medical history, including any past diagnosis of tuberculosis or other related diseases.
5. Answer the screening questions related to tuberculosis, such as whether you have been coughing for longer than two weeks or if you have been in contact with someone diagnosed with TB.
6. If you have had a TB skin test (Mantoux test) or chest X-ray, record the results and the date they were done.
7. If you have any symptoms related to tuberculosis, make sure to describe them accurately.
8. Sign the form and date it to confirm that the information provided is truthful and accurate.

Who needs tuberculosis TB screening form:

1. Individuals who have been in close contact with someone diagnosed with tuberculosis may need to fill out a TB screening form.
2. People who have traveled to or lived in areas with a high incidence of tuberculosis may also be required to complete a TB screening form.
3. Healthcare workers and individuals working in settings that involve close contact with potentially infected individuals may need to undergo regular TB screening and complete the corresponding form.

For pdfFiller’s FAQs

What is tuberculosis tb screening form?

The tuberculosis tb screening form is a document used to gather information about an individual's potential exposure to tuberculosis and their health status in relation to the disease.

Who is required to file tuberculosis tb screening form?

The individuals who are required to file the tuberculosis tb screening form are usually those who have been in close contact with a known tuberculosis case or those who are at higher risk of being infected with tuberculosis.

How to fill out tuberculosis tb screening form?

To fill out the tuberculosis tb screening form, you need to provide accurate information about your personal details, medical history, recent travel, and any potential tuberculosis exposure. You may also need to undergo medical tests to complete the form.

What is the purpose of tuberculosis tb screening form?

The purpose of the tuberculosis tb screening form is to identify individuals who may have been exposed to tuberculosis and to assess their risk of infection. It helps in preventing the spread of tuberculosis and ensures appropriate medical follow-up for those at risk.

What information must be reported on tuberculosis tb screening form?

The tuberculosis tb screening form typically asks for information such as personal details, contact information, medical history, recent travel, potential tuberculosis exposure, and results of medical tests related to tuberculosis.

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