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Form to Document Refusal of Treatment for Latent
You have been identified as being infected with the tuberculosis (TB) germ. As explained to you earlier, you have a lifetime risk of developing TB disease.
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Refusal of Treatment for Latent TB Infection
By signing this form I am acknowledging my refusal to accept the treatment plan recommended by the CDC for the management of LTBI. In refusing this treatment I
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Infectious Disease Management
Jun 3, 2014 This form will identify inmates known to be HIV positive, or under treatment for exposure to, or active TB. (4) To the physician/provider of a
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