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California State University, Los Angeles Student Health Center Rev. 7/21/11 Information (323) 343-3301 FAX: (323) 343-6557 Housing Services TUBERCULOSIS VERIFICATION (See Reverse Side for Instructions)

How to fill out housing services tuberculosis verification

To fill out the housing services tuberculosis verification, follow these steps:

1. Start by carefully reviewing the form to understand the information required.
2. Provide your personal details accurately, such as your name, address, and contact information.
3. Fill in the specific details related to your tuberculosis status, including the date of your most recent tuberculosis test and the results.
4. If you have been diagnosed with tuberculosis, provide additional information about your treatment plan, such as the medications you are taking and the duration of the treatment.
5. In case you have completed tuberculosis treatment, mention the date of completion and any additional information requested about your treatment.
6. Sign and date the form to certify that the information provided is true and accurate.
7. Keep a copy of the filled-out form for your records.
8. Submit the completed tuberculosis verification form to the appropriate housing services department.

Anyone who is seeking housing services and is required to provide tuberculosis verification needs to complete this form. This typically includes individuals applying for public housing, subsidized housing, or other housing programs where such a verification is mandated. Additionally, individuals who have been diagnosed with tuberculosis or have recently completed tuberculosis treatment may also need to fill out this verification form when applying for certain housing services.

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What is housing services tuberculosis verification?

Housing services tuberculosis verification is a process that confirms the presence or absence of tuberculosis within a housing facility.

Who is required to file housing services tuberculosis verification?

Housing service providers or organizations that offer accommodations must file housing services tuberculosis verifications.

How to fill out housing services tuberculosis verification?

To fill out housing services tuberculosis verification, providers need to gather relevant data such as number of residents, tuberculosis test results, and any reported cases of tuberculosis.

What is the purpose of housing services tuberculosis verification?

The purpose of housing services tuberculosis verification is to ensure the safety and well-being of residents by monitoring and preventing the spread of tuberculosis within housing facilities.

What information must be reported on housing services tuberculosis verification?

Housing services tuberculosis verification requires reporting of the number of residents, tuberculosis test results, and any confirmed cases of tuberculosis within the facility.

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