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LIBERTY HEALTHCARE CORPORATION AND AFFILIATES (LIBERTY) TUBERCULOSIS SCREENING WAIVER FORMEmployee/Subcontractor Name: ___ (Please Print Clearly)Today\'s Date: ___ Date of Last Chest Ray: ___N/AUnknownPlease
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How to fill out tuberculosis screening testing and

01
Follow the instructions provided by the healthcare provider for the tuberculosis screening testing.
02
Provide a sputum sample as requested by the healthcare provider.
03
If a skin test is being used, have a small amount of solution injected under the skin of the forearm and return within 48-72 hours to check for a reaction.
04
Follow up with the healthcare provider for the test results and any necessary follow-up care.

Who needs tuberculosis screening testing and?

01
Individuals who have been in close contact with someone who has active tuberculosis.
02
People with symptoms of tuberculosis, such as persistent cough, weight loss, fever, and night sweats.
03
Healthcare workers who are at risk of exposure to tuberculosis in their work environment.
04
Individuals with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or taking immunosuppressive medications.
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Tuberculosis screening testing is a medical procedure used to detect the presence of TB bacteria in a person's lungs or other parts of the body.
Individuals who are at high risk for tuberculosis or have been in contact with someone with active TB are required to undergo and file tuberculosis screening testing.
Tuberculosis screening testing can be filled out by a healthcare provider or medical professional who administers the test and reports the results to the appropriate health authorities.
The purpose of tuberculosis screening testing is to identify and treat individuals who have latent TB infection or active TB disease in order to prevent the spread of the disease to others.
The information reported on tuberculosis screening testing includes the individual's personal details, test results, and any recommended treatment or follow-up care.
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