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Click ‘Get Form’ to open the TB screening form in the editor.
Begin with SECTION I: INFORMATION/CONSENT. Fill in your name, department, and signature. Ensure you read the consent information carefully before signing.
Proceed to SECTION II: RISK ASSESSMENT. Answer each question by checking 'Yes' or 'No'. Provide additional details where necessary, especially regarding past TB tests and symptoms.
In SECTION III: PPD ADMINISTRATION, record the date given and site of administration (right or left forearm). If applicable, note the second step date and PPD lot number.
Complete SECTION V: INTERPRETATION and REFERRAL by entering the date read and results in millimeters for both steps. Ensure the reader's signature is included.
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TB screening involves the active identification of people at risk for TB disease. Populations or high-risk groups are screened by assessing symptoms and by using tests, examinations or other procedures that can be applied rapidly. TB screening is sometimes also referred to as active TB case finding. Tuberculosis: Systematic screening - World Health Organization (WHO) World Health Organization questions-and-answers item sy World Health Organization questions-and-answers item sy
What is a TB screening form?
You can get tested for TB at the health department or at your health care providers office. Your health care provider will choose the TB test that is best for you. Public and private health care plans may cover TB testing costs.
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