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California State University, Long Beach School of Nursing Physical Exam Form Last Name: First: MI: DOB: SID: Phone # () Email: Health Background Information: Two-Step TB Skin Test Procedure: Official
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How to fill out tb test ppd lot
How to fill out tuberculin examination report form:
01
Start by entering the patient's personal information, including their name, date of birth, and contact information.
02
Indicate the date and time the tuberculin examination was performed.
03
Specify the type of test administered, such as a Mantoux or TST (Tuberculin Skin Test).
04
Record the size of the induration or bump observed at the test site.
05
Include any relevant medical history or previous tuberculosis (TB) exposure.
06
If the patient has a known TB infection, note the current treatment being received.
07
Document any symptoms or signs of TB, such as coughing, weight loss, or night sweats.
08
Indicate if the patient has any previous positive TB test results.
09
Provide information on any recent contact with individuals diagnosed with TB.
10
Sign and date the form to validate the report.
11
Remember to submit the completed form to the appropriate healthcare provider or organization.
Who needs tuberculin examination report form:
01
Individuals undergoing employment or immigration medical screening.
02
Healthcare workers who may have occupational exposure to TB.
03
Students in certain educational or training programs, particularly in healthcare fields.
04
Individuals residing in or entering certain congregate settings, such as correctional facilities or homeless shelters.
05
People who have been in contact with someone diagnosed with TB.
06
Individuals with symptoms suggestive of TB infection.
07
Patients being monitored for TB treatment progress or clearance.
Note: The specific requirements and regulations regarding the need for a tuberculin examination report form may vary depending on the country and organization.
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What is tuberculin examination report form?
The tuberculin examination report form is a document used to record the results of a tuberculin skin test, which helps in diagnosing tuberculosis infection.
Who is required to file tuberculin examination report form?
Healthcare providers, including doctors and clinics, are required to file the tuberculin examination report form for patients who undergo a tuberculin skin test.
How to fill out tuberculin examination report form?
To fill out the tuberculin examination report form, a healthcare provider must enter the patient's personal information, test date, test results, and any relevant history of exposure to tuberculosis.
What is the purpose of tuberculin examination report form?
The purpose of the tuberculin examination report form is to document the test results, facilitate communication between healthcare providers, and support public health efforts in monitoring and controlling tuberculosis.
What information must be reported on tuberculin examination report form?
The information that must be reported on the tuberculin examination report form includes the patient's name, date of birth, date of the test, test results, and any previous history of tuberculosis treatment or exposure.
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