Get the free Tuberculosis Referral - Alberta Health Services

To refer for Tuberculosis follow-up recommendation, please complete all sections of this form, and return with x- ray report by fax or mail to one of the following ...

How to fill out tuberculosis referral - alberta

How to fill out tuberculosis referral - alberta

1. To fill out a tuberculosis referral in Alberta, follow these steps:
2. Obtain the tuberculosis referral form from your healthcare provider or download it from the Alberta Health Services website.
3. Fill out your personal information, including your full name, date of birth, address, and contact information.
4. Provide your healthcare provider's information, including their name, address, and contact details.
5. Indicate whether you have been previously diagnosed with tuberculosis and provide relevant details if applicable.
6. Describe your symptoms, if any, and provide a detailed medical history related to tuberculosis.
7. If known, provide the name and contact information of the healthcare professional who made the initial diagnosis of tuberculosis.
8. Sign and date the referral form, acknowledging that the information provided is accurate to the best of your knowledge.
9. Submit the completed tuberculosis referral form to your healthcare provider or the designated healthcare facility.

Who needs tuberculosis referral - alberta?

1. In Alberta, tuberculosis referral may be needed for the following individuals:
2. - Individuals who exhibit symptoms associated with tuberculosis, such as persistent cough, weight loss, night sweats, and fever.
3. - Individuals who have been in close contact with someone diagnosed with active tuberculosis.
4. - Individuals who have received a positive result from a tuberculosis screening test.
5. - Individuals at high risk of tuberculosis, such as immigrants from countries with a high prevalence of tuberculosis, healthcare workers, and individuals with compromised immune systems.
6. It is important to consult with a healthcare provider to determine if a tuberculosis referral is necessary in your specific case.

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What is tuberculosis referral - alberta?

Tuberculosis referral in Alberta is a process where healthcare providers refer individuals suspected or diagnosed with tuberculosis to the appropriate public health authorities for further evaluation and management.

Who is required to file tuberculosis referral - alberta?

Healthcare providers and facilities are required to file tuberculosis referral in Alberta for individuals suspected or diagnosed with tuberculosis.

How to fill out tuberculosis referral - alberta?

Tuberculosis referral in Alberta can be filled out by healthcare providers using the designated forms provided by the public health authorities.

What is the purpose of tuberculosis referral - alberta?

The purpose of tuberculosis referral in Alberta is to ensure that individuals suspected or diagnosed with tuberculosis receive appropriate evaluation, treatment, and follow-up to prevent the spread of the disease.

What information must be reported on tuberculosis referral - alberta?

Tuberculosis referral in Alberta must include the individual's demographics, medical history, symptoms, diagnostic test results, and contact information.