Get the free tuberculosis declination form

Tuberculosis Declination Form Name Program Student Record Positive Reactor Checklist Our records indicate you are a positive reactor to the TB Mantoux test.

How to fill out tuberculosis declination form

How to fill out tuberculosis declination form

1. Obtain the tuberculosis declination form from your healthcare provider or institution.
2. Read the instructions carefully before starting to fill out the form.
3. Provide your personal information, including your name, date of birth, and contact details.
4. Indicate your reason for declining the tuberculosis test by selecting the appropriate option.
5. Sign and date the form to acknowledge your understanding of the declination.
6. Submit the completed form to the designated office or person as instructed.

Who needs tuberculosis declination form?

1. Individuals who have a medical condition that prevents them from undergoing tuberculosis testing.
2. Employees or students in environments where tuberculosis testing is required but wish to decline.
3. Individuals who have previously tested positive for tuberculosis and are under treatment.

For pdfFiller’s FAQs

What is tuberculosis declination form?

The tuberculosis declination form is a document that individuals sign to indicate their decision not to undergo tuberculosis screening or testing, usually due to personal, health, or religious reasons.

Who is required to file tuberculosis declination form?

Individuals who are mandated to undergo tuberculosis screening as part of employment requirements, especially in healthcare settings, are required to file a tuberculosis declination form if they choose not to participate in the testing.

How to fill out tuberculosis declination form?

To fill out a tuberculosis declination form, individuals typically need to provide personal information such as their name, date, the reason for declination, and any relevant signature that acknowledges their decision not to be tested.

What is the purpose of tuberculosis declination form?

The purpose of the tuberculosis declination form is to document an individual's choice not to participate in tuberculosis testing, ensuring that employers or organizations are aware of this decision and can take appropriate measures.

What information must be reported on tuberculosis declination form?

The information that must be reported on a tuberculosis declination form includes the individual's name, contact information, the date of declination, the specific reasons for declining the testing, and the individual's signature.