CONFIDENTIAL MORBIDITY REPORT San Diego County TB: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient's last name, first name, and middle initial in the designated fields. Ensure accuracy as this information is crucial for identification.
Select the patient's ethnicity by checking the appropriate box. This helps in understanding demographic data related to tuberculosis cases.
Fill in the home address, including street number, city, state, and ZIP code. Include contact numbers and email for follow-up communication.
Indicate the patient's gender and age by filling in years, months, and days as applicable. Also, provide the birth date in mm/dd/yyyy format.
Complete sections regarding occupational exposure settings by checking all that apply. This information is vital for epidemiological tracking.
Document TB treatment information accurately, including test results and treatment initiation dates. This section is critical for patient management.

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