TB Questionnaire - Sutter Health 2025

1. Click ‘Get Form’ to open the TB Questionnaire in our editor.
2. Begin by selecting whether you are a New Hire, Annual, or Post Exposure by checking the appropriate box.
3. Fill in your personal details including your name, job title, date of birth, workplace site, department, and employee ID number in the designated fields.
4. Answer the questions regarding your TB history by checking 'Yes' or 'No' for each item. Provide additional details if necessary in the text fields provided.
5. If applicable, indicate whether you prefer to discuss any 'Yes' answers with an Employee Health physician.
6. Sign and date the form at the bottom to acknowledge that your lab test results will be part of your medical record.
7. Once completed, save your document and return it via email or fax to your Employee Health Division as instructed.

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