TB-400A TB Reporting Form 2026

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The document is a report form for tuberculosis (TB) case and patient services, detailing patient information, medical history, testing results, and treatment plans. It includes sections for demographic data, risk factors, prior treatments, and administrative notes related to TB management.

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Click ‘Get Form’ to open the TB-400A TB Reporting Form in our editor.
Begin by entering the 'Date reported to health department' at the top of the form. This is crucial for tracking the case timeline.
Fill in the patient's personal information, including their name, date of birth, and address. Ensure accuracy as this data is vital for identification.
Indicate the initial reporting source by selecting from options such as Health Department or Private Physician. This helps categorize how cases are reported.
Complete the medical history section, checking all applicable boxes regarding previous treatments and medical risks. This information aids in assessing patient needs.
Finally, ensure that you sign and date the form at the bottom before submitting it. This confirms that all provided information is accurate and complete.

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Versions	Form popularity	Fillable & printable
2020	4.9 Satisfied (55 Votes)
2018	4.5 Satisfied (60 Votes)
2003	4 Satisfied (42 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does TB look like under the microscope?

Your provider will measure the size of the firmness of the bump. Your provider considers your particular risk factors to determine the results of your test. Youre considered positive if your bump is: Greater than or equal to 5 millimeters (mm) and you have a compromised immune system.

What is a TB screening form?

To be completed by student. This document is a screening tool used to determine potential exposure to active Tuberculosis.

What are the microscopic findings of tuberculosis?

Microscopic Findings The inflammation with MTB infection is granulomatous, with epithelioid macrophages and Langhans giant cells along with lymphocytes, plasma cells, maybe a few neutrophils (PMNs), and fibroblasts with collagen. Ongoing inflammation is characteristic caseous necrosis in the center of granulomas.

How to report TB microscopy?

TB Laboratory Register for smear and Xpert MTB/RIF TB Laboratory Register for smear and Xpert MTB/RIF. 2 Y=Yes; N=No; Unk = unknown. 3 Y = previously treated; N = not previously treated, Unk = unknown. 5 Xpert MTB/RIF test result reported as follows : T = MTB detected, rif resistance not detected;

Does TB require mandatory reporting?

Tuberculosis (TB) disease is a nationally notifiable disease, and reporting is mandated in all U.S. states.

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How to report an afb stain?

Normal and Critical Findings No Acid-fast bacilli (AFB) seen - Report as 0. 1-9 AFB in 1 length - Record the actual number of AFB seen (e.g. +1, +2, +9). 10-99 AFB in 1 length - Report as 1+. 1-10 AFB per field in at least 50 visual fields - Report as 2+.

Does TB need to be reported?

Providers are required to report all cases and suspected cases to the appropriate local public health agency.

TB-400A TB Reporting Form 2026

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