Get the free PPD Screening Form - Temple University Student Health Services
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PPD Screening Forename: TU ID: PPD Given: (Date)Lot #: L R Forearm (Circle)Expiration: (Name and Title) (Signature)Please check one: BaselineFollow Up (2 Step)AnnualExposure (Baseline)Exposure (12
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How to fill out ppd screening form
How to fill out ppd screening form
01
To fill out the PPD screening form, follow these steps:
02
Start by entering your personal information, such as your name, date of birth, and contact details.
03
Provide your medical history, including any previous positive TB tests or TB treatment.
04
Answer the screening questions about your exposure to tuberculosis and any symptoms you may have.
05
Indicate if you have any underlying medical conditions or are taking medications that may affect the interpretation of the test results.
06
Sign and date the form to certify the accuracy of the provided information.
07
Submit the completed form to the relevant healthcare provider or authority for further processing.
Who needs ppd screening form?
01
Anyone who is required to undergo tuberculosis (TB) screening may need to fill out the PPD screening form.
02
This includes individuals at high risk of TB exposure, such as healthcare workers, individuals living or working in congregate settings (e.g., correctional facilities, homeless shelters), and those who have recently traveled to areas with high TB prevalence.
03
Additionally, individuals with suspected TB symptoms or those who have been in close contact with someone diagnosed with active TB may also need to complete the PPD screening form.
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What is ppd screening form?
The ppd screening form is a document used to assess individuals for tuberculosis infection.
Who is required to file ppd screening form?
Healthcare workers and individuals at high risk for tuberculosis infection are required to file the ppd screening form.
How to fill out ppd screening form?
The ppd screening form should be filled out by providing personal information, medical history, and the results of the tuberculin skin test.
What is the purpose of ppd screening form?
The purpose of the ppd screening form is to identify individuals who may have been exposed to tuberculosis and need further testing or treatment.
What information must be reported on ppd screening form?
The ppd screening form must include personal details, medical history, date of tuberculin skin test, and result of the test.
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