Get the free Tuberculosis Contact Investigation Form - idph state ia

This document serves as a form to investigate contacts related to tuberculosis cases, outlining criteria, requirements, and guidelines for conducting contacts investigations.

How to fill out tuberculosis contact investigation form

How to fill out Tuberculosis Contact Investigation Form

1. Obtain the Tuberculosis Contact Investigation Form from your local health department or website.
2. Start by filling out the patient’s personal information, including name, address, and contact details.
3. Include the date of diagnosis for the tuberculosis case.
4. List the known contacts of the tuberculosis patient, providing their names, addresses, and relationship to the patient.
5. Record the dates of exposure for each contact if available.
6. Indicate any additional information relevant to the contacts, such as age or medical history.
7. Sign and date the form to verify that the information provided is accurate and complete.
8. Submit the completed form to the appropriate public health authority.

Who needs Tuberculosis Contact Investigation Form?

1. Individuals who have been in close contact with someone diagnosed with tuberculosis.
2. Health care providers managing tuberculosis cases.
3. Public health officials for tracking and managing tuberculosis outbreaks.

For pdfFiller’s FAQs

What is Tuberculosis Contact Investigation Form?

The Tuberculosis Contact Investigation Form is a document used to identify and assess individuals who have been in close contact with a person diagnosed with tuberculosis (TB), facilitating necessary follow-up and testing.

Who is required to file Tuberculosis Contact Investigation Form?

Healthcare providers and public health officials are required to file the Tuberculosis Contact Investigation Form when a patient is diagnosed with TB to ensure that all potential contacts are investigated.

How to fill out Tuberculosis Contact Investigation Form?

To fill out the Tuberculosis Contact Investigation Form, provide accurate patient details, list all close contacts, assess their risk factors, and record any symptoms. Follow the guidelines provided by your local health department.

What is the purpose of Tuberculosis Contact Investigation Form?

The purpose of the Tuberculosis Contact Investigation Form is to track and manage the spread of TB by ensuring that individuals who have been in contact with an infected person are identified, screened, and if necessary, treated.

What information must be reported on Tuberculosis Contact Investigation Form?

Information that must be reported includes the names and contact information of the patient and their contacts, the nature and duration of the contact, any symptoms observed, and the results of any TB tests performed.