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Click ‘Get Form’ to open the Santa Clara County TB Risk Assessment Form in the editor.
Begin by entering the child's name and birthdate at the top of the form. Ensure you specify their gender and school information accurately.
Fill in the address and phone number fields, including street, city, and zip code. This information is crucial for communication purposes.
In the risk assessment section, answer each question regarding potential exposure to tuberculosis. Select 'Yes' or 'No' for each item based on your child's history.
If any questions are answered 'Yes', ensure to note down any relevant test results for Tuberculin Skin Test (TST) or Interferon Gamma Release Assay (IGRA) in the designated areas.
Finally, have a licensed health professional complete their section by signing and dating the form before submission to the child’s school.

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Can I do a TB risk assessment online?

Complete your TB risk assessment online through the myUOHealth portal.

Who can complete a TB risk assessment in California?

It depends on if you have risk factors for tuberculosis infection. If youre at a higher risk for TB, your healthcare provider may recommend yearly TB testing.

How to get a TB risk assessment?

Who may administer the TB risk assessment? Per California Education and Health and Safety Codes, the TB risk assessment is to be administered by a health care provider. The risk assessment should be administered face-to-face.

Does Walgreens do TB assessments?

Walgreens offers TB testing at select locations. Go to Walgreens.com or use the Walgreens App and select Find Care to find a site near you. TB Control Offices located in various cities, states and territories, and primary and urgent care clinics in your area may also offer TB testing. Published November 2020.

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Got questions?

Can I do a TB risk assessment online?

Who can complete a TB risk assessment in California?

How to get a TB risk assessment?

Does Walgreens do TB assessments?

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Santa clara county tb risk assessment form 2025

Here's how it works

How to use or fill out Santa Clara County TB Risk Assessment Form with our platform

Complete this form in 5 minutes or less

Got questions?

Can I do a TB risk assessment online?

Who can complete a TB risk assessment in California?

How to get a TB risk assessment?

Does Walgreens do TB assessments?

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Try more PDF tools