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TB Risk AssessmentName:___ Birthdate___ Address:___Phone:___Please answer the following questionsYESNOHave you had temporary or permanent residence of 1 month in a country with a high TB rate? (Any
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01
Review the questions on the annual TB screening questionnaire.
02
Fill out the questionnaire honestly and accurately.
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Provide any necessary information or details required on the form.
04
Sign and date the form once completed.
05
Submit the completed questionnaire to the appropriate healthcare provider or employer as directed.

Who needs annual tb screening questionnaire?

01
Individuals who work in healthcare settings where they may be exposed to TB patients.
02
Individuals who have traveled or lived in high TB prevalence areas.
03
Those with HIV infection or other medical conditions that increase the risk of developing TB.
04
People in close contact with someone diagnosed with active TB disease.
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The annual TB screening questionnaire is a form used to assess an individual's exposure to tuberculosis and their risk factors for the disease, typically required for specific professions or educational settings.
Individuals working in healthcare, education, or other high-risk environments, as well as students in certain programs, are typically required to file the annual TB screening questionnaire.
To fill out the annual TB screening questionnaire, individuals should answer all questions truthfully regarding their health, exposure history, and any previous TB tests or treatments, and submit the form as directed by their institution or employer.
The purpose of the annual TB screening questionnaire is to identify individuals who may be at risk for tuberculosis and to ensure appropriate screening and preventive measures are taken.
The questionnaire typically requires information about personal health history, signs or symptoms of TB, past TB tests, exposure to TB-positive individuals, and any relevant travel history.
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