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Tuberculosis Sign & Symptom Review Michigan 2026

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The document is a Tuberculosis Sign & Symptom Review form designed for individuals with a history of positive TB tests who have been evaluated and ruled out for active TB disease. It includes sections for personal information, previous test details, treatment history, and a checklist of symptoms to assess potential TB-related issues. The form emphasizes the need for further evaluation if symptoms or abnormal chest x-ray results are present.

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Click ‘Get Form’ to open the Tuberculosis Sign & Symptom Review Michigan in the editor.
Begin by entering your name, date of birth, and personal identifier in the designated fields. This information is crucial for accurate record-keeping.
Fill in the date you completed the form and the date of your previous positive TB test. Indicate whether it was an IGRA or TST test by checking the appropriate box.
Provide details about your last chest x-ray, including the date and results. This section helps healthcare providers assess your current health status.
Answer whether you have taken medications following your positive TB test. If yes, confirm if you completed the entire course by selecting 'Yes' or 'No'.
In the Sign and Symptom Review section, indicate if you have experienced any listed symptoms for more than two weeks by checking 'Yes' or 'No' for each symptom.

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Versions	Form popularity	Fillable & printable
2019	4.5 Satisfied (31 Votes)
2017	4.5 Satisfied (30 Votes)

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What are the 4 cardinal signs of TB?

The most common symptoms of TB are chronic cough, fever, especially rising in the evening, night sweats, chest pain, weight loss, loss of appetite, coughing up blood.

What are the five stages of tuberculosis?

Laboratory tests Generally, at least three sputum samples are collected and sent to a laboratory for testing. Your health care provider may also collect a sample, take tissue samples, or do other tests. These tests can find TB germs that may be outside your lungs.

What are the five signs and symptoms of tuberculosis?

Active TB disease. Cough. Coughing up blood or mucus. Chest pain. Pain with breathing or coughing. Fever. Chills. Night sweats. Weight loss.

What is the 4 symptom screening for TB?

For children aged 10 years, a four-symptom screen is used (current cough or fever or weight loss or night sweats). For children aged 10 years, consider their history of contact with TB or reported or confirmed weight loss or growth curve flattening or weight for age 2 Z-scores.

What are the red flags for tuberculosis?

Common symptoms of active TB disease include cough, pain in the chest, and coughing up blood or sputum (phlegm). People with inactive TB, also called latent TB infection, do not have symptoms of TB disease and cannot spread TB to others.

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