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DEPARTMENT OF HEALTH SERVICES Division of Public Health F02314D (02/2020)STATE OF WISCONSIN Page 1 of 2WISCONSIN TUBERCULOSIS (TB) RISK ASSESSMENT AND SYMPTOM EVALUATION FOR ANNUAL EMPLOYEE SCREENING

How to fill out wisconsin tuberculosis tb risk

How to fill out wisconsin tuberculosis tb risk

1. To fill out the Wisconsin Tuberculosis (TB) Risk form, follow these steps:
2. Download the Wisconsin TB Risk form from the official website.
3. Read all the instructions and guidelines provided with the form.
4. Gather all the necessary information required to fill out the form, such as personal details, medical history, and contact information.
5. Begin by entering your personal details accurately, including your full name, date of birth, and current address.
6. Provide your medical history related to Tuberculosis, including any previous diagnosis, treatment, or exposure to TB.
7. Answer all the questions on the form honestly and to the best of your knowledge.
8. Double-check all the information you have provided to ensure accuracy.
9. Sign the form at the designated space to certify that the information provided is true and accurate.
10. Submit the completed form as instructed, either by mail or in person, to the appropriate authority.
11. Keep a copy of the filled-out form for your records.
12. Remember, it is important to follow the instructions and provide accurate information while filling out the Wisconsin TB Risk form.

Who needs wisconsin tuberculosis tb risk?

1. Anyone who resides in or has recently visited Wisconsin and is at risk of tuberculosis (TB) needs to fill out the Wisconsin TB Risk form.
2. This may include individuals who have been in close contact with someone diagnosed with TB, individuals with symptoms or signs of TB infection, individuals with a weakened immune system, or individuals from countries with a high incidence of TB.
3. It is important to consult with healthcare professionals or the appropriate authorities to determine if you fall under the category of individuals who need to fill out the Wisconsin TB Risk form.

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What is wisconsin tuberculosis tb risk?

Wisconsin tuberculosis TB risk refers to the assessment of the likelihood of individuals in Wisconsin being exposed to and contracting tuberculosis.

Who is required to file wisconsin tuberculosis tb risk?

Healthcare providers, laboratories, and other entities involved in the diagnosis and treatment of tuberculosis are required to file Wisconsin tuberculosis TB risk assessments.

How to fill out wisconsin tuberculosis tb risk?

Wisconsin tuberculosis TB risk assessments can be filled out online or through paper forms provided by the Wisconsin Department of Health Services.

What is the purpose of wisconsin tuberculosis tb risk?

The purpose of Wisconsin tuberculosis TB risk assessments is to monitor and track the prevalence of tuberculosis in the state, as well as to identify and prevent outbreaks.

What information must be reported on wisconsin tuberculosis tb risk?

Information reported on Wisconsin tuberculosis TB risk assessments includes patient demographics, symptoms, test results, and potential exposure sources.