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DEPARTMENT OF HEALTH SERVICES Division of Public Health F00905 (09/2021)SUBMIT COMPLETED FORM TO:TUBERCULOSIS INFECTION INITIAL REQUEST FOR MEDICATIONSTATE OF WISCONSIN Wis. Stats 252.10 (7) Wisconsin

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How to fill out tuberculosis infection initial request

01

Obtain the necessary form for the tuberculosis infection initial request from the appropriate health department or medical facility.

02

Fill out the form completely and accurately, providing all required information such as personal details, medical history, and symptoms.

03

Include any relevant medical documentation or test results that support the need for the tuberculosis infection initial request.

04

Submit the completed form to the designated contact or office as instructed by the health department or medical facility.

Who needs tuberculosis infection initial request?

01

Individuals suspected of having tuberculosis infection and requiring further testing or treatment.

02

Healthcare providers or facilities conducting screenings or diagnosis for tuberculosis infection.

03

Public health officials or organizations tracking and monitoring tuberculosis cases.

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What is tuberculosis infection initial request?

The tuberculosis infection initial request is a formal notification submitted to the appropriate health authorities to report a suspected or confirmed case of tuberculosis.

Who is required to file tuberculosis infection initial request?

Healthcare providers, laboratories, and other healthcare facilities are required to file tuberculosis infection initial request when a suspected or confirmed case of tuberculosis is identified.

How to fill out tuberculosis infection initial request?

The tuberculosis infection initial request form must be completed with detailed information about the patient, including demographics, symptoms, diagnostic test results, and treatment plan.

What is the purpose of tuberculosis infection initial request?

The purpose of tuberculosis infection initial request is to ensure timely reporting of tuberculosis cases to facilitate public health intervention and control measures.

What information must be reported on tuberculosis infection initial request?

Information reported on tuberculosis infection initial request includes patient demographics, symptoms, diagnostic test results, treatment plan, and healthcare provider contact information.

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