Get Report Form For Tuberculin Test (tb Test) - Alexandria City Public ...

Filling out the Report Form for Tuberculin Test is an essential step for individuals looking to verify their tuberculosis status for employment purposes. This guide offers clear instructions on how to complete the form online, ensuring you understand each section and its requirements.

Follow the steps to fill out the form accurately

1. Click ‘Get Form’ button to retrieve the Report Form for Tuberculin Test and open it in your document editor.
2. In the first section, enter your full name in the 'Name' field. Ensure that it matches the name on your identification documents.
3. In the 'Last 4-digits of SS#' field, carefully enter the last four digits of your Social Security number. This information is required for identity verification.
4. In the 'Results - Risk Assessment' section, identify your risk status by marking 'No Risk Identified' if applicable or 'Needs PPD' if further testing is necessary.
5. If you have undergone a PPD test, fill out the 'Results of PPD' section by indicating if the test was 'Negative' or 'Positive' according to your results.
6. If your results required a chest x-ray, document those results in the 'Chest X-Ray Results (If indicated)' section. Leave blank if not applicable.
7. In the 'Comments' section, provide any additional relevant information or notes that may assist health officials in their assessment.
8. The form must be signed by a licensed physician, nurse, or public health official. Ensure that their signature is included in the designated area.
9. Complete the 'Name of Physician/Nurse/Health Official' and 'Address' sections accurately to ensure proper documentation.
10. Finally, enter the contact 'Telephone' number of the health provider to facilitate follow-up if necessary.
11. Once all sections of the form are completed, review the document for accuracy. Save any changes, and you may choose to download, print, or share the form as required.

Start filling out your Tuberculin Test Report Form online today for efficient processing.