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Tb test form california

Tb screening form 2026

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The document is a TB Screening Form designed to collect personal information and medical history related to tuberculosis (TB) screening. It includes sections for the individual's name, birthdate, reasons for screening, medical conditions, previous TB tests, symptoms, and risk factors. The form also outlines staff assessment and follow-up plans based on the individual's responses.

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Click ‘Get Form’ to open the tb screening form in the editor.
Begin by entering your name and birthdate at the top of the form. This information is essential for identification purposes.
In the section labeled 'TELL US THE REASON(S) FOR YOUR TB SCREENING TODAY', check all applicable boxes and provide any necessary details in the space provided.
Proceed to answer the questions regarding your medical history. For each question, select 'Yes' or 'No' and provide additional information where prompted, such as country of birth and year entered the USA.
Continue through the symptoms section, marking any that apply to you. Ensure you complete all relevant fields for accurate assessment.
Finally, review your entries for accuracy before signing and dating the form at the bottom. This confirms that all information is true to your knowledge.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (121 Votes)

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