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ESSD Tuberculosis Risk Assessment Form Students Name:___Date of Birth:___The Centers for Disease Control and Prevention and the United States Public Health Service recommend tuberculosis skin testing
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How to fill out tuberculosis risk assessment form
How to fill out tuberculosis risk assessment form
01
Gather all relevant information such as medical history, recent travel history, exposure to tuberculosis, and any symptoms experienced.
02
Fill out personal information section including name, date of birth, address, and contact information.
03
Answer questions related to risk factors such as previous diagnosis of tuberculosis, close contact with someone diagnosed with tuberculosis, and immunosuppressive conditions.
04
Provide information on current symptoms such as cough, fever, weight loss, and night sweats.
05
Submit the completed form to a healthcare provider for review and further evaluation.
Who needs tuberculosis risk assessment form?
01
Individuals who have been in close contact with someone diagnosed with tuberculosis.
02
Individuals with symptoms suggestive of tuberculosis such as persistent cough, fever, and weight loss.
03
Healthcare workers who may be at increased risk of exposure to tuberculosis.
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What is tuberculosis risk assessment form?
The tuberculosis risk assessment form is a document used to evaluate the risk factors associated with tuberculosis infection.
Who is required to file tuberculosis risk assessment form?
Healthcare facilities and employers are required to file tuberculosis risk assessment form.
How to fill out tuberculosis risk assessment form?
The form must be completed by providing information about the individual's risk factors for tuberculosis infection.
What is the purpose of tuberculosis risk assessment form?
The purpose of tuberculosis risk assessment form is to assess the risk of tuberculosis infection in individuals.
What information must be reported on tuberculosis risk assessment form?
Information such as medical history, exposure to tuberculosis, and symptoms of tuberculosis must be reported on the form.
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