Get Tuberculosis (tb) Medical Clearance Form University ...

Filling out the TUBERCULOSIS (TB) MEDICAL CLEARANCE FORM is essential for ensuring the health and safety of the university community. This guide provides you with detailed instructions to complete the form accurately and efficiently online.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name and date of birth in the designated fields. Ensure that the information provided matches your official documents.
3. Next, input your student ID number accurately to identify your records within the university system.
4. Complete the testing section by selecting one of the options for tuberculosis testing: either the Tuberculin Skin Test (PPD) or the TB blood test (IGRA: QuantiFERON or T-SPOT). Make your selection based on any previous history of the BCG vaccine. If you have a history of the BCG vaccine, it is preferred to choose the TB blood test.
5. Enter the date the test was placed and the date it was read. Record the result in millimeters (mm) of induration if applicable.
6. Mark the interpretation of your test result, indicating whether it was negative, positive, or indeterminate. If the result is indeterminate, you may need to repeat the test.
7. Proceed to complete the chest x-ray section if required, entering the date of the x-ray and the result of the examination. Make sure to attach the necessary x-ray report.
8. If applicable, provide your TB treatment history, including any medication, start date, and duration of therapy. Alternatively, indicate if treatment was explained and the patient declined.
9. Finally, a licensed health care provider must certify that the student is free of active TB disease by providing their signature, printed name, and phone number along with the date.
10. Once all fields are filled out accurately, you can save your changes, download a copy, print the form, or share it as needed.

Complete your TUBERCULOSIS (TB) MEDICAL CLEARANCE FORM online today for a hassle-free process.