Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering the name of the youth in the designated field. Ensure that the spelling is correct to avoid any confusion.
3. Enter the DJJID# in the appropriate box. This is essential for identification purposes.
4. Input the date of birth of the youth. This helps in verifying their identity and age.
5. Move to section I, starting with tuberculosis screening. Fill in the results of the PPD/TST test, including the location and source, in the provided fields. Ensure to include multiple entries if applicable.
6. Indicate whether the youth has ever had a chest x-ray by selecting 'YES' or 'NO'. If 'YES', complete the additional details regarding the results and location.
7. Check 'YES' or 'NO' to indicate if the youth has ever received medication for latent TB or active tuberculosis disease, and provide any relevant drug names and dates.
8. Proceed to section II to indicate whether the youth has been tested for other communicable diseases such as chlamydia, gonorrhea, and syphilis by selecting the appropriate responses.
9. For section III on hepatitis, fill out where the screening occurred and respond with the results for Hepatitis A, B, and C.
10. In section IV, indicate if the youth has been treated for viral or bacterial meningitis and provide details if applicable.
11. Section V requires you to check if the youth has had a staphylococcal infection. Provide additional details about the infection's location and treatment if necessary.
12. If there are any other medical conditions to describe, complete section VI accordingly.
13. Finally, ensure all fields are completed and accurate. After reviewing, you can save the form, download a copy, print it, or share it as needed.

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