Tuberculosis, Canada - the Tennessee Department of Health 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Part 1, where you will enter your personal information. Fill in your family name, given names, maiden name, address, phone numbers, gender, ethnic origin, date of birth, and country of birth. Ensure all fields are completed accurately.
3. In Part 2, the nurse will complete sections regarding the reason for the exam and any risk factors for developing TB. Make sure to provide accurate contact information and specify any symptoms you may have experienced.
4. Proceed to Part 3 where you will indicate if you have ever had TB or been in contact with a TB case. This section is crucial for your medical history.
5. Finally, in Part 4, a physician will complete the chest X-ray results. Ensure that all recommendations are noted clearly.

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