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Virginia tb screening form 2026
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- Click ‘Get Form’ to open the Virginia TB Screening Form in our editor.
- Begin by entering the date at the top of the form. This is essential for record-keeping.
- Fill in your name and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
- In the section labeled 'TO WHOM IT MAY CONCERN', specify the name of the health department or facility that conducted your evaluation.
- Indicate whether a tuberculin skin test (PPD) is indicated by checking the appropriate box based on your symptoms and history.
- If applicable, provide details regarding any chest x-ray results, including dates and findings, ensuring you check the correct box for either normal or abnormal results.
- Finally, have a qualified MD or Health Department Official sign and date the form, along with their address and phone number.
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tb screening form va
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