PROVIDENCE HEALTH CENTER TB SKIN TEST RECORD 2025

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  1. Click ‘Get Form’ to open the PROVIDENCE HEALTH CENTER TB SKIN TEST RECORD in the editor.
  2. Begin by entering the patient's name, date of birth, and the current date in the designated fields at the top of the form.
  3. Proceed to answer the vaccination question. Check 'Yes' or 'No' and provide details if applicable.
  4. For each symptom listed, indicate 'Yes' or 'No'. If you select 'Yes', be sure to fill in the approximate date when symptoms started.
  5. In the consent section, enter your name and sign where indicated. Ensure that you also provide a date for this consent.
  6. Complete any additional information required under 'DO NOT WRITE BELOW THIS LINE', including test details and results.

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Who can administer and read TB skin tests? The TB skin test should be placed (administered) and read by a designated, trained health care provider. Consult with your state and local public health authorities to determine who is authorized to place and read TB skin tests in your state.
Ask your health care provider for a written record of your positive TB skin test result.
Positive TB test Tests that diagnose active TB infections include chest X-rays and laboratory tests on a sputum sample. Sputum is the thick mucus that you cough up from your lungs. Its different from spit or saliva. Youll need treatment for TB, whether its latent or active.
Keep a record of your positive test result This includes even after you finish taking all of your TB medicine for inactive TB or active TB disease. Ask your health care provider for a written record of your positive TB skin test result.
The results should be read between 48 and 72 hours after administration. A patient who does not return within 72 hours will probably need to be rescheduled for another TST. Visually inspect injection site under good light, and measure induration (thickening of the skin), not erythema (reddening of the skin).
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The skin test involves receiving a small injection in your forearm and measuring the small bump, or induration, that appears after 48 to 72 hours. Depending on the size of the induration and your risk of TB exposure, the doctor will determine whether you tested positive or negative for TB.
There are two tests that are used to determine if a person has been infected with TB bacteria: TB blood tests (Interferon Gamma Release Assay [IGRA]) and the TB skin test (Mantoux tuberculin skin test).

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