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Tuberculosis Clearance Statement Texas Women University Student Health Services Phone: 940.898.3826Fax: 940.898.3849Name: TWU ID#: Date of Birth: TWU students with positive Tuberculosis (TB) Blood
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How to fill out tuberculosis clearance statement
How to fill out tuberculosis clearance statement
01
Obtain a tuberculosis clearance statement form from the relevant authority or healthcare provider.
02
Fill out your personal details such as name, address, date of birth, and contact information.
03
Provide details of any previous tuberculosis tests or treatments you have undergone.
04
Answer questions regarding your medical history, including any past or current respiratory conditions.
05
If required, provide information about recent travel to areas with a high prevalence of tuberculosis.
06
Sign and date the form to certify the accuracy of the information provided.
07
Submit the completed form to the designated authority or healthcare provider for review and processing.
Who needs tuberculosis clearance statement?
01
Individuals who are required to provide evidence of their tuberculosis status may need a tuberculosis clearance statement. Common examples include:
02
- Individuals applying for a visa or residency permit in a foreign country
03
- Students enrolling in educational institutions (both domestic and international)
04
- Healthcare workers
05
- Employees working in certain industries or occupations where there is a risk of tuberculosis transmission
06
- Individuals participating in certain research studies or clinical trials
07
- Military personnel
08
- Individuals seeking admission to a long-term care facility or rehabilitation center
09
- Individuals adopting or fostering children
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What is tuberculosis clearance statement?
The tuberculosis clearance statement is a document used to certify that an individual has been tested and found not to have active tuberculosis.
Who is required to file tuberculosis clearance statement?
Anyone working in environments where there is a risk of exposure to tuberculosis, such as healthcare workers or employees in correctional facilities, may be required to file a tuberculosis clearance statement.
How to fill out tuberculosis clearance statement?
To fill out a tuberculosis clearance statement, individuals must undergo a tuberculosis test and have a healthcare provider complete the form verifying the results.
What is the purpose of tuberculosis clearance statement?
The purpose of the tuberculosis clearance statement is to ensure that individuals working in high-risk environments do not have active tuberculosis and are not putting others at risk of infection.
What information must be reported on tuberculosis clearance statement?
The tuberculosis clearance statement typically includes the individual's name, date of birth, date of tuberculosis test, test results, and healthcare provider information.
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