Mandatory Tuberculosis Screening Form M4 Medical Students 2014 ... - med fau-2026

1. Click ‘Get Form’ to open the Mandatory Tuberculosis Screening Form in the editor.
2. Begin by entering your personal information: Last name, First name, Middle Initial, Student Z number, Birth date, Gender, and Permanent street address. Ensure all fields are filled accurately.
3. For the REQUIRED SCREENING section, document your Tuberculin Skin Test (PPD) results. Indicate whether the test was positive or negative and provide the date of the test.
4. If you had a positive PPD, complete the Tuberculosis Screening Questionnaire. Fill in your personal information again and answer questions regarding your medical history related to TB.
5. Ensure that a healthcare provider certifies your information by providing their printed name, signature, and official stamp in the designated area.
6. Once completed, download or save your form directly from our platform for submission to the FAU Immunization Office by May 2, 2014.

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