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TUBERCULOSIS (TB) SCREENING FORMTODAYS DATE: ___/___/___A. REASSESSMENT (TO BE COMPLETED BY PATIENT OR PARENT / GUARDIAN) Name: Last:___ First:___ Middle:___Date of Birth: ___/___/___ Address: ___
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How to fill out tuberculosis tb screening form

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How to fill out tuberculosis tb screening form

01
Obtain the TB screening form from the designated healthcare facility.
02
Provide your personal information such as name, date of birth, and contact details.
03
Answer the questions regarding your medical history and any past exposure to tuberculosis.
04
Describe any symptoms you may be experiencing related to TB such as coughing, chest pain, or weight loss.
05
If required, undergo any necessary tests such as a chest x-ray or TB skin test.
06
Submit the completed form to the healthcare provider for review and further guidance.

Who needs tuberculosis tb screening form?

01
Anyone who is at risk of tuberculosis infection or has symptoms suggestive of tuberculosis should fill out a TB screening form.
02
Individuals working in healthcare settings, correctional facilities, homeless shelters, or other high-risk environments may also need to undergo TB screening.
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Tuberculosis TB screening form is a document used to assess individuals for TB infection or disease.
Individuals working in certain industries or living in crowded environments may be required to file TB screening form.
The form typically requires personal information, medical history, and results of TB tests.
The purpose of the form is to identify individuals who may have TB infection or disease.
Information such as TB test results, medical history, and personal details are typically reported on the form.
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