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11 - Sample FGP-SCP TB Test Form 2026

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The document is a sample TB Test Form for the ABC Foster Grandparent/Senior Companion Program, outlining the requirements for tuberculosis testing for volunteers. It includes sections for personal information, test results, and provider details, as well as a separate screening form for those with a history of positive TB tests. The document emphasizes that while TB tests are not mandatory by Senior Corps, they may be required by certain sponsoring agencies.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name and date of birth in the designated fields at the top of the form.
Fill in your address and phone number accurately to ensure proper communication.
If you have had a positive TB test previously, skip the TB test section and proceed to the next page.
For those taking the test, enter the PPD test date and date read in their respective fields.
Indicate the number of millimeters of induration and provide results/interpretation as required.
Complete the provider information section, including health professional signature, hospital/clinic name, and date.
If applicable, fill out the Positive Tuberculosis Screening Form on the second page with accurate details regarding past tests and treatments.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (151 Votes)
2017	4.5 Satisfied (30 Votes)

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