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Click ‘Get Form’ to open the Two-Step PPD Form in the editor.
Begin by entering your Name and University ID at the top of the form. This information is essential for identification purposes.
Select your Program by checking the appropriate box. Ensure you choose one that accurately reflects your current academic status.
Fill in the Date field with the current date when you are completing this form.
For the First PPD Test section, enter the Date of your first test and provide a Signature. Remember not to start this step on a Thursday.
Complete the Facility Name, Address, and Phone Number fields where you received your first PPD test.
Record the First PPD Reading Date and Results within 48 hours of taking the first test, along with another Signature and Facility details.
Repeat similar steps for the Second PPD Test and Reading sections, ensuring all dates and results are accurately filled out.
If applicable, complete the Interferon Gamma Release Assay (IGRA) section by circling T-Spot or Quantiferon and noting any positive results.

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