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Mantoux test report format

Mantoux test report format 2026

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The document is a 2 Step TB form required for students to submit their tuberculosis (TB) status. It includes sections for student information, TB skin test results, and chest x-ray results, along with signatures from health care providers. The form outlines the process for documenting TB status and provides alternatives if a TB skin test cannot be performed.

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Click ‘Get Form’ to open the mantoux test report format in the editor.
Begin by entering the 'Student Name' in the designated field. Ensure that you print the name clearly for legibility.
Next, input your 'UF-ID' in the corresponding section. This identification number is crucial for record-keeping.
Sign your name in the 'Student Signature' field to authenticate the document.
For TB Skin Test #1, fill in the 'Date Given' and 'Date Read'.
Have a health care provider sign and indicate whether the result is 'Positive' or 'Negative'.
Repeat steps 5 and 6 for TB Skin Test #2, ensuring all information is accurate.
If applicable, provide details for a chest x-ray, including the 'Date Read' and results.

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