Get the free Tuberculosis Risk Assessment Form - Fraser Health

Name of Person in Care: TUBERCULOSIS RISK ASSESSMENT FORM FOR PERSON IN CARE OF COMMUNITY CARE FACILITIES LESS THAN 60 YEARS OLD Residents less than 60 years old: if any of the following risk factors

How to fill out tuberculosis risk assessment form

How to fill out tuberculosis risk assessment form

1. Read the instructions on the tuberculosis risk assessment form carefully.
2. Start by providing your personal information such as name, age, and contact details.
3. Answer the questions regarding your medical history, such as any previous history of tuberculosis or exposure to tuberculosis patients.
4. Fill in the details about any current symptoms you may be experiencing, such as persistent cough, weight loss, or night sweats.
5. If you have been tested for tuberculosis in the past, indicate the date of the test and the result.
6. Provide information about any recent travel to countries where tuberculosis is prevalent.
7. Answer additional questions on risk factors such as living or working in close contact with individuals who have active tuberculosis.
8. Ensure you answer honestly and accurately to the best of your knowledge.
9. Once you have completed all the sections of the form, review it to make sure all the information provided is correct.
10. Sign and date the tuberculosis risk assessment form and submit it as required.

Who needs tuberculosis risk assessment form?

1. Individuals who suspect they may have been exposed to tuberculosis.
2. Individuals with symptoms such as persistent cough, weight loss, or night sweats.
3. People with a known history of tuberculosis or who have been in close contact with tuberculosis patients.
4. Healthcare professionals conducting screenings or assessments for tuberculosis.
5. Individuals planning to travel to countries where tuberculosis is prevalent.

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What is tuberculosis risk assessment form?

Tuberculosis risk assessment form is a document used to evaluate an individual's risk of contracting tuberculosis.

Who is required to file tuberculosis risk assessment form?

Healthcare professionals and individuals in high-risk settings are required to file tuberculosis risk assessment form.

How to fill out tuberculosis risk assessment form?

Tuberculosis risk assessment form can be filled out by providing relevant personal and medical information, as well as answering questions related to exposure and symptoms.

What is the purpose of tuberculosis risk assessment form?

The purpose of tuberculosis risk assessment form is to identify individuals at risk of tuberculosis and implement appropriate preventive measures.

What information must be reported on tuberculosis risk assessment form?

Information such as personal details, medical history, exposure to tuberculosis, and symptoms must be reported on tuberculosis risk assessment form.