Get Tuberculosis (tb) Health Assessment Form ... - Ucsb Student...
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How to fill out the Tuberculosis (TB) Health Assessment Form - UCSB Student online
The Tuberculosis (TB) Health Assessment Form is a crucial document for students at the University of California, Santa Barbara, ensuring their safety and health prior to enrollment in classes. This guide provides step-by-step instructions to help you navigate the process of completing this form online successfully.
Follow the steps to complete your TB health assessment form online.
- Press the ‘Get Form’ button to acquire the Tuberculosis (TB) Health Assessment Form and open it for editing.
- Begin by filling in the 'Name of Student' section at the top of the form.
- Enter the 'Date of Birth' in the format month/day/year.
- Provide your 'Perm#', which is essential for identification purposes.
- Answer all the history questions by selecting 'Yes' or 'No' and adding comments where necessary, ensuring all six questions are addressed.
- For any affirmative responses, follow the instructions for additional requirements, such as ordering tests or providing documentation.
- Complete the 'Testing' section by choosing between the TB Blood Test (IGRA) or Tuberculin Skin Test (TST) and documenting results accordingly.
- If applicable, fill out the chest x-ray details and attach the written radiology report.
- Document the sputum results if required, entering the dates and results for each smear and culture.
- Lastly, ensure the licensed healthcare provider completes their section by providing their signature, printed name, date, and office stamp if required.
- After completing all sections, save the changes, download the completed form, print it, or share it as needed.
Complete your Tuberculosis (TB) Health Assessment Form online today for a smooth enrollment process!
Mandatory Tuberculosis Screening. Tuberculosis (TB) screening is required for all persons born outside the United States, regardless of the status of their application. Screening for TB must be administered, regardless of prior BCG vaccination, no more than six months prior to the first day of class.
Fill Tuberculosis (TB) Health Assessment Form ... - UCSB Student...
Has the student ever been treated for active TB disease? If yes, must attach summary of treatment letter and chest x-ray within the last 12 months. All incoming students must complete a five question Tuberculosis Screening Questionnaire which is located on the Clearances tab in your MyHealth portal. Carefully read and follow the instructions on the TB Health Assessment Form. Incomplete forms will not be accepted and you will NOT be cleared. All incoming students must complete a TB Risk Screening Questionnaire. This form is located under the "Clearances" tab in the MyHealth Portal. If the screening prompts you to submit your TB Testing Form, please complete steps 5-8 below. 5. Print the TB Health Assessment Form (page 2 of this document). TB screening questionnaire for students to assess TB risk.
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