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Tuberculosis Screening FormMorehouse School of Medicine Student Health / Employee Health Wellness Center Phone: (404) 6164600 Email: SHWCrequests MSM. Edams / MHC Volunteer Other Name: Date of Birth:

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How to fill out tuberculosis annual screening form

01

To fill out the tuberculosis annual screening form, follow these steps:

02

Start by providing your personal information such as your name, date of birth, and contact details.

03

Mention your medical history related to tuberculosis, including any previous diagnosis, treatments, and medications.

04

If applicable, fill in information about your current respiratory symptoms or any recent exposure to tuberculosis.

05

Answer the questions regarding your lifestyle and habits that might increase the risk of tuberculosis, such as traveling to high-risk areas or being in close contact with infected individuals.

06

If you have recently undergone any tuberculosis-related tests or examinations, provide the details in the designated section.

07

Finally, review all the information provided and make sure it is accurate and complete. Sign and date the form before submitting it.

Who needs tuberculosis annual screening form?

01

The tuberculosis annual screening form is usually required for individuals who fall under the following categories:

02

- People with a known history of tuberculosis

03

- Individuals with weakened immune systems

04

- Healthcare workers who have direct contact with tuberculosis patients

05

- Individuals residing or working in high-risk settings such as correctional facilities, homeless shelters, or nursing homes

06

- Those who have recently traveled to countries with a high incidence of tuberculosis

07

- Individuals who have been in close contact with someone diagnosed with active tuberculosis

08

- People seeking employment or admission in certain fields that require tuberculosis screening as a precautionary measure

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What is tuberculosis annual screening form?

The tuberculosis annual screening form is a document used to assess and track the health status of individuals for tuberculosis infection.

Who is required to file tuberculosis annual screening form?

Individuals working in certain occupations or settings that pose a higher risk of tuberculosis exposure are required to file the tuberculosis annual screening form.

How to fill out tuberculosis annual screening form?

The tuberculosis annual screening form typically requires individuals to provide personal information, medical history, and undergo a tuberculosis screening test.

What is the purpose of tuberculosis annual screening form?

The purpose of the tuberculosis annual screening form is to monitor and prevent the spread of tuberculosis by identifying individuals who may be infected.

What information must be reported on tuberculosis annual screening form?

Information such as personal details, medical history, previous tuberculosis exposure, and screening test results must be reported on the tuberculosis annual screening form.

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