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MCCM Student Tuberculosis Attestation Form -One Year Or Less Program - MC0945-118. MCCM Student Tuberculosis Attestation Form -One Year Program - Student Tuberculosis TB Attestation Authorization Year Program Clinic College Medicine Science MCCMS For 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the student's full name, including first, middle, and last names in the designated field.
- Input the birth date in the format mm-dd-yyyy to ensure accurate record keeping.
- Fill in the student’s street address, including city, state, and ZIP code for proper identification.
- Select the program name and enter the program start date using the mm-dd-yyyy format.
- Complete the tuberculosis screening section by providing test dates and results for either a skin test or blood test as required.
- Ensure that a health care provider signs and dates the form, including their printed name and license number.
- If applicable, have a parent or legal guardian sign if the student is under 18 years of age.
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