Kentucky form tb 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name, date of birth, race, sex, and social security number in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the address details including city, state, and zip code. Provide contact numbers and indicate if the patient is pregnant along with their last menstrual period (LMP) if applicable.
4. In Section I, check all active TB symptoms that apply. If none are present, skip to Section II.
5. Proceed to Section II and assess risk factors for latent TB infection. Check relevant boxes based on the patient's history and exposure.
6. Complete Sections III and IV by checking any findings or actions taken regarding the patient's TB risk assessment.
7. Finally, ensure all signatures are provided where required before saving or sharing the completed form.

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