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NAME: ___ TB SYMPTOM REVIEW 1. 2. 3. 4. 5. 6. Do you have any medication or food allergies? Yes (please list): No Have you taken steroids, immunosuppressants or cancer drugs in the last 8 weeks? Yes

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How to fill out tb-hep b annual form

01

Step 1: Obtain the tb-hep b annual form from your healthcare provider or employer.

02

Step 2: Fill out your personal information including name, address, date of birth, and contact information.

03

Step 3: Provide information about your tuberculosis and hepatitis B vaccination history.

04

Step 4: Sign and date the form to certify that the information provided is accurate.

05

Step 5: Submit the completed form to the designated recipient (e.g. healthcare provider, employer).

Who needs tb-hep b annual form?

01

Individuals who have previously been diagnosed with tuberculosis or hepatitis B

02

Healthcare workers who may be at risk of exposure to tuberculosis or hepatitis B

03

Employers who require annual health screenings for their employees

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What is tb-hep b annual form?

The tb-hep b annual form is a document used to report tuberculosis and hepatitis B cases for a specified period of time.

Who is required to file tb-hep b annual form?

Healthcare providers, laboratories, and healthcare facilities are required to file tb-hep b annual form.

How to fill out tb-hep b annual form?

To fill out the tb-hep b annual form, you must provide information about the number of tuberculosis and hepatitis B cases reported, demographic information, and any related treatment or prevention measures.

What is the purpose of tb-hep b annual form?

The purpose of the tb-hep b annual form is to track and monitor the incidence of tuberculosis and hepatitis B in a specific population.

What information must be reported on tb-hep b annual form?

Information such as the number of cases, demographics of the affected individuals, treatment provided, and any preventive measures taken must be reported on the tb-hep b annual form.

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