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FOOTHILL DE ANZA COMMUNITY COLLEGE DISTRICT Office of Human Resources & Equal Opportunity TUBERCULIN RISK ASSESSMENT/TB TEST FORM To satisfy job related requirements in the California Education Code
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How to fill out tuberculin risk assessmenttb test

01
To fill out the tuberculin risk assessmenttb test, follow these steps:
02
Obtain a tuberculin risk assessment form from a healthcare provider or clinic.
03
Read the instructions on the form carefully to understand the information required.
04
Provide your personal details such as name, age, gender, and contact information.
05
Answer the questions related to your medical history, previous tuberculosis exposure, and any symptoms you may be experiencing.
06
If you have recently traveled to or lived in an area with a high prevalence of tuberculosis, make sure to mention it.
07
Provide information about any previous tuberculin skin tests you may have had and their results.
08
If you have any underlying medical conditions or are on any medications, disclose that information as well.
09
Complete all sections of the form accurately and truthfully.
10
Once you have filled out the form, review it to ensure all information is correct.
11
Sign and date the form.
12
Submit the completed tuberculin risk assessmenttb test form to the healthcare provider or clinic as per their instructions.

Who needs tuberculin risk assessmenttb test?

01
The tuberculin risk assessmenttb test is needed for individuals who may be at risk of tuberculosis infection.
02
This includes:
03
- Healthcare workers who frequently come in contact with patients or individuals with tuberculosis
04
- People living in or traveling to areas with a high prevalence of tuberculosis
05
- Close contacts of individuals diagnosed with active tuberculosis
06
- People with HIV infection or other conditions that weaken the immune system
07
- Individuals who have received organ transplants or are on immunosuppressive therapy
08
- Individuals with symptoms suggestive of tuberculosis infection such as persistent cough, night sweats, weight loss, and fatigue.
09
It is important to consult with a healthcare provider to determine if you need a tuberculin risk assessmenttb test based on your specific circumstances and medical history.
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Tuberculin risk assessment or TB test is a test that helps determine if a person has been infected with the bacteria that causes tuberculosis.
Certain individuals, such as healthcare workers or individuals in close contact with TB patients, may be required to undergo tuberculin risk assessment TB test.
The tuberculin risk assessment TB test is typically administered by a healthcare provider and involves injecting a small amount of purified protein derivative (PPD) into the skin. The provider then checks for a reaction at the injection site within a few days.
The purpose of the tuberculin risk assessment TB test is to determine if a person has been infected with tuberculosis bacteria, even if they do not have active symptoms of the disease.
The information reported on a tuberculin risk assessment TB test may include the individual's name, date of birth, date of testing, and test results.
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