Ppd skin test form 2025

1. Click ‘Get Form’ to open the PPD Skin Test Record Form in the editor.
2. Begin by entering the patient information. Fill in the name, address, city/town, state, zip code, and telephone numbers (home and cell/work) in the designated fields.
3. Next, provide student information if applicable. Enter the Student ID number and class year in their respective fields.
4. In the Skin Test Information section, input the administrator's name, date/time administered, arm on which the test was given, manufacturer of PPD solution, expiration date of PPD solution, and lot number.
5. Record the results by noting the induration measurement in mm and the date/time of reading. If there are any comments or adverse reactions, document them in the provided space.
6. Finally, have a healthcare provider print their name and title (MD/RN/MA), sign where indicated, and enter the date.

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