Get Uhs Umich

This guide provides step-by-step instructions for completing the Uhs Umich form, required for international students seeking tuberculosis screening at the University of Michigan. By following these instructions, users will ensure that they correctly fill out the necessary documentation for their screening appointment.

Follow the steps to accurately complete the form online.

1. Press the ‘Get Form’ button to access the Uhs Umich form and open it in the designated editor.
2. In the 'Patient' section, enter your last name followed by your first name, ensuring that you provide your full legal names as they appear on official documents.
3. Fill in your date of birth by selecting the month, day, and year from the provided fields.
4. Indicate which tuberculosis test you have undergone by checking the appropriate box for either 'QuantiFERON-TB Gold' or 'T-SPOT.TB test'.
5. Next, enter the date when the test was completed, selecting the day, month, and year.
6. In the 'Result' section, mark the box that corresponds to your test result: 'Negative', 'Indeterminate', or 'Positive', based on the outcome of your screening.
7. If applicable, describe your treatment for tuberculosis in detail, including relevant dates, to provide necessary context for health care providers.
8. Find the 'Health Care Provider Who Completed this Form' section. Input the printed name and signature of the health care provider who conducted your test.
9. Lastly, include the provider’s street address, city, state, and postal code. If they are located outside the USA, specify the country.
10. Once all fields are filled out, you can save your changes, download a copy for your records, print the form, or share it as needed.

Complete your Uhs Umich form online today!