Get U.s. Dod Form Dod-navmed-6224-1 - U.s. Federal Forms

This guide provides clear, step-by-step instructions for accurately completing the U.S. DOD Form Dod-navmed-6224-1, which is essential for documenting tuberculosis exposure and testing. Follow the outlined steps to ensure your form is filled out correctly and efficiently online.

Follow the steps to accurately complete the U.S. DOD Form Dod-navmed-6224-1.

1. Press the ‘Get Form’ button to access the document and open it in your online editor.
2. Begin with Section I: Contact/reactor identification. Fill in your last name, first name, and middle initial. Then, include your grade/rate, age, and sex. Provide your social security number (SSN), the date of completion, and your duty station.
3. In Section I, check the appropriate boxes for tuberculosis contact or reactor follow-up. Indicate whether you are an untreated or treated known previous reactor or a new reactor, specifying the appropriate category.
4. Move to Section II: Exposure history. If known, enter the name of the original case, their grade/rate, the place of exposure, and the dates of exposure. If applicable, include your SSN or relationship to the original case.
5. For Section III: Contact/reactor prior record, document the last three skin test readings in millimeters (mm) along with the corresponding dates. Next, list the last three chest film readings.
6. In Section IV: Initial examination, provide skin test results in mm, including the dates and film number. Record chest X-ray results and the location where taken. Include any history and physical findings, such as smear and culture results if conducted.
7. Proceed to Section V: Follow-up examination-contact study. Fill in scheduled and performed dates for follow-up examinations, including skin test or X-ray results and testing location for the 3 months and 6 months follow-up periods.
8. Complete Section VI: monitoring history by entering the date and findings as necessary.
9. Review your entries for accuracy. When satisfied, you can save changes, download, print, or share the completed form for your records.

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