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LATENT TUBERCULOSIS INFECTION RECORD LAST NAME: FIRST NAME: MI: Birth Date: / / Age: PHONE :() ADDRESS: CITY: COUNTY: STATE: ZIP SEX RACE ETHNICITY REASON FOR TESTING RESIDENCE COUNTRY OF BIRTH MALE
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Latent tuberculosis infection record is a record used to document individuals who have been infected with tuberculosis but do not show any symptoms of the disease.
Healthcare providers and facilities are required to file latent tuberculosis infection records for patients who have been diagnosed with latent tuberculosis.
Latent tuberculosis infection records can be filled out by providing the patient's demographic information, test results for tuberculosis infection, and any other relevant medical history.
The purpose of latent tuberculosis infection record is to monitor and track individuals who have been infected with tuberculosis but are not showing symptoms in order to prevent the spread of the disease.
The information that must be reported on a latent tuberculosis infection record includes the patient's name, date of birth, test results for tuberculosis infection, date of diagnosis, and any relevant medical history.
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