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Get the free REQUEST FOR QUANTIFERON-TB GOLD ... - NJ.gov

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State of New Jersey Department of Health Public Health and Environmental Laboratories 3 Schwarzkopf Drive, Ewing, NJ 08628 https://www.nj.gov/health/phel/REQUEST FOR QUANTIFERONTB GOLD / MYCOBACTERIOLOGY
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How to fill out request for quantiferon-tb gold

01
Obtain a requisition form for the quantiferon-tb gold test from your healthcare provider.
02
Fill out your personal information such as name, date of birth, and contact information on the form.
03
Provide a brief medical history including any past exposure to tuberculosis or symptoms of the disease.
04
Return the completed form to your healthcare provider or the laboratory where the test will be conducted.

Who needs request for quantiferon-tb gold?

01
Individuals who have been exposed to tuberculosis or are at risk of contracting the disease.
02
People who have symptoms of tuberculosis such as cough, fever, weight loss, and night sweats.
03
Healthcare workers who may have been in contact with tuberculosis patients.
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A request for QuantiFERON-TB Gold is a formal submission for conducting a blood test used to detect latent tuberculosis infection.
Healthcare providers or clinicians who suspect a patient may have latent TB infection are required to file this request.
The request form should be filled out with patient information, the reason for testing, and any relevant medical history, ensuring all sections are complete and accurate.
The purpose is to identify individuals with a latent TB infection so that they can receive appropriate treatment to prevent the development of active TB disease.
Information required includes patient demographics, clinical reasons for testing, date of birth, healthcare provider information, and any relevant medical history.
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