Austin Community College TB Test Documentation Form for Levels 2-4 and Readmitted Students 2014-2025 free printable template

TB Test Documentation Form for Levels 2-4 and Readmitted Students Last Name First Name MI Maiden Report results are required for all tests submitted. Tuberculosis must show proof of See excerpt from CDC website below from Latent Tuberculosis Infection Date Given Positive Negative Read by a. Documentation of a negative tuberculin skin test TST - 10mm Read Date OR Date b. Negative blood assay QFT TSPOT c* IF a prior positive reactor to TST must show documentation of a negative blood assay QFT...

How to fill out Austin Community College TB Test Documentation

How to fill out a TB skin test form:

1. Make sure you have the necessary information and materials before starting. This may include your personal identification details, medical history, and the TB skin test form itself.
2. Begin by accurately filling out your personal information, such as your full name, date of birth, and contact information. Providing your social security number or any other unique identification number may also be required.
3. Next, provide details about your medical history that are relevant to the TB skin test. This may include any past or present respiratory conditions, previous TB diagnosis or treatment, or recent exposure to someone with TB.
4. On the form, you will typically find a section to record the dates of the tests. Write down the date when the TB skin test was administered and the date you need to return for the results.
5. Complete any other sections on the form that are specific to your situation or requirements. This may involve answering additional questions about recent travels, immunizations, or any known allergies.
6. Ensure that you carefully read through the entire form for accuracy and completeness. Double-check your answers before submitting the form to avoid any discrepancies or mistakes.
7. Sign and date the form as required to validate your consent and agreement with the provided information.
8. Return the completed form to the relevant healthcare provider or facility as instructed.

Who needs a TB skin test form?

1. Individuals who suspect they have been exposed to TB or have symptoms related to TB may need a TB skin test form. This includes people who have had close contact with someone diagnosed with active TB or individuals working or living in high-risk environments such as healthcare settings, correctional facilities, or homeless shelters.
2. Anyone immigrating from a country with a high prevalence of TB may also be required to complete a TB skin test and provide the corresponding form.
3. Additionally, individuals who are applying for certain jobs or programs, such as healthcare professionals, students in clinical settings, or volunteers in certain institutions, may need to undergo TB testing and complete the associated form. The specific requirements may vary depending on the organization or institution's policies and regulations.

People Also Ask about

What is a TB assessment form?

The purpose of this tool is to identify adults with infectious tuberculosis (TB) to prevent them from spreading disease.

How often do you need a TB risk assessment?

Repeat risk assessment and testing Repeat risk assessments should occur every four years (unless otherwise required) to identify any additional risk factors, and TB testing based on the results of the TB risk assessment.

What is a TB test assessment?

The TB skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin on the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.

What are the 4 questions for TB screening?

Please answer the following questions: Have you ever had a positive TB skin test? Have you ever had close contact with anyone who was sick with TB? Have you ever been vaccinated with BCG? * The significance of the travel exposure should be discussed with a health care provider and evaluated.

How do you document a PPD skin test?

Name and signature of person administering test. Date and time test administered. Location of test (e.g., right forearm, left forearm, alternate site) Tuberculin manufacturer, lot number and expiration date.

How long does a TB assessment last?

6. How long is the test valid? A negative test is valid for 2 years and must not expire at any time during the semester.

How is a TB risk assessment done?

For persons with TB symptoms,4 abnormal chest x-ray consistent with TB disease, or a positive TST or IGRA: Evaluate for active TB disease by obtaining a chest x-ray, symptom screen, performing a physical exam and if indicated,5 sputum testing (i.e., AFB smears, cultures and nucleic acid amplification).

What is the protocol for TB test?

The TST is performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The injection should be made with a tuberculin syringe, with the needle bevel facing upward. The TST is an intradermal injection.

How do you write TB skin test results?

Record Record the exact measurement in millimeters of induration on the Mantoux Tuberculin Skin Test Record Form. Record the date and time the test was read, the name and signature of the person who read the skin test, and the presence or absence of adverse effects (i.e., blistering, redness, and swelling)

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What is Austin Community College TB Test Documentation Form?

The Austin Community College TB Test Documentation Form is a form used to verify that a student or employee has undergone tuberculosis (TB) screening and is free from the disease.

Who is required to file Austin Community College TB Test Documentation Form?

Students entering health-related programs and certain employees are required to file the Austin Community College TB Test Documentation Form.

How to fill out Austin Community College TB Test Documentation Form?

To fill out the form, individuals must provide personal information, details of the TB screening conducted, including the type of test and results, and any additional required documentation.

What is the purpose of Austin Community College TB Test Documentation Form?

The purpose of the form is to ensure that individuals are tested for TB to protect public health and comply with college and state health regulations.

What information must be reported on Austin Community College TB Test Documentation Form?

The form must report personal identification details, type of TB test administered (e.g., skin test or blood test), the date the test was given, interpretation of the results, and any follow-up actions if necessary.