Get the free Tuberculosis Contact Notification

This document serves to inform individuals identified as having been in close contact with someone who has multidrug-resistant tuberculosis (MDR-TB). It details the necessary steps for receiving evaluations including chest X-ray (CXR) and latent TB infection (LTBI) tests.

How to fill out tuberculosis contact notification

How to fill out tuberculosis contact notification

1. Obtain the tuberculosis contact notification form from your local health department or tuberculosis control program.
2. Fill in the patient's details including name, date of birth, and contact information.
3. Provide information about the type of tuberculosis (active or latent) the patient has.
4. List the names and contact details of all close contacts of the patient who may need to be notified.
5. Indicate the dates of potential exposure to tuberculosis for each contact listed.
6. Sign and date the form to certify that the information is true and complete.
7. Submit the completed notification form to the appropriate health authorities.

Who needs tuberculosis contact notification?

1. Individuals who have been in close contact with a person diagnosed with active tuberculosis.
2. Family members, friends, or co-workers who spent significant time with the infected individual.
3. Healthcare workers who may have been exposed to the patient in a clinical setting.
4. Children and immunocompromised individuals who are at higher risk of contracting tuberculosis.

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What is tuberculosis contact notification?

Tuberculosis contact notification is the process of informing individuals who have been in close contact with a person diagnosed with tuberculosis (TB) about their potential exposure to the disease, encouraging them to get tested and seek medical advice.

Who is required to file tuberculosis contact notification?

Healthcare providers and public health officials are typically required to file tuberculosis contact notifications to ensure that individuals at risk of infection are informed and receive the appropriate follow-up care.

How to fill out tuberculosis contact notification?

To fill out a tuberculosis contact notification, one should provide information about the TB patient, including their contact details, the nature of the exposure, and the list of contacts who might be at risk for having contracted TB.

What is the purpose of tuberculosis contact notification?

The purpose of tuberculosis contact notification is to prevent the spread of TB by ensuring that individuals who may have been exposed to the disease are informed, tested, and treated if necessary.

What information must be reported on tuberculosis contact notification?

The information that must be reported on tuberculosis contact notification includes the name and contact information of the TB patient, the date of diagnosis, details of the exposure, and a list of individuals who were in close contact with the patient.