2 step ppd form 2025

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  1. Click ‘Get Form’ to open the 2 step ppd form in the editor. Begin by entering your name, last and first, along with your GCCCD student ID number.
  2. In Step #1, fill in the date of the test, manufacturer details, dose (0.1mL), time given, expiration date, and lot number. Ensure that the administering professional signs and dates this section.
  3. Record the results of the test in mm and note the time read. The reading professional must also sign this section.
  4. If your Mantoux test is positive, indicate this and ensure a chest x-ray report is attached before submission.
  5. Repeat similar steps for Step #2, ensuring all fields are completed accurately at least 7 days after Step #1.

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To perform a two-step TST, administer and read the first TST. If the result is negative, repeat a second TST one to four weeks later (no sooner than one week and no later than four weeks later.) The result of the second TST is the true baseline.
At time of administration: Name and signature of person administering test. Date and time test administered. Location of test (e.g., right forearm, left forearm, alternate site) Tuberculin manufacturer, lot number and expiration date.
The two-step tuberculin skin test (TST) is used to detect individuals with past tuberculosis (TB) infection who now have diminished skin test reactivity. This procedure will reduce the likelihood that a boosted reaction is later interpreted as a new infection.
The 2-step PPD test, or tuberculin skin test, is used to detect individuals with past tuberculosis (TB) infection. It is done in a four appointment schedule: Visit 1: Place the first PPD Visit 2: 48-72 hours later, the PPD is read. Visit 3: 1-3 weeks after Visit 1, the second PPD is placed.
The two-step test is NOT the usual PPD skin test in which you receive an injection of PPD and the test area is observed one time at specific time frame. The two-step PPD test is used to detect individuals with past TB infection who now have diminished skin test reactivity.

Key Facts about the Mantoux Tuberculin Skin Test Requirements at Grossmont College

Two-Step Testing Requirement

Annual Testing Mandate

Documentation for Positive Results

Authorized Signatures

Chest X-Ray Requirement for Positives

Repeat Testing Protocols

Mantoux Conversion Monitoring

Two-Step Testing Requirement

All Health Profession students must complete a 2-step intradermal TST (Mantoux) before starting their program, unless they have a previous positive result.

Annual Testing Mandate

Students are required to undergo an annual TB test or submit a questionnaire regarding their TB status each year.

Documentation for Positive Results

If a student has a positive Mantoux test, they must provide documentation of the positive result and a clear chest x-ray to be eligible for the Nursing Program.

Authorized Signatures

Only specific healthcare professionals, including Physicians, Physician Assistants, Nurse Practitioners, Registered Nurses, or Grossmont College Health Services Nurses can sign and stamp this form.

Chest X-Ray Requirement for Positives

A chest x-ray is mandatory if the Mantoux test result is positive, and a copy of the report must be submitted with the form.

Repeat Testing Protocols

If there is no documentation of a negative TB test within 12 months prior to entering the program, students must repeat the Two-Step Mantoux Test.

Mantoux Conversion Monitoring

Students who experience a conversion from negative to positive (induration > 10mm) must not attend classes until cleared by a negative chest x-ray report.

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The test may be done at any local health department, primary care clinic, doctors office, CVS, Walgreens etc. 4. Why is the 2-step TB skin test needed? Some people infected with M.

2 step tb test form