Get Ca All Health Services Tuberculosis Screening Questionnaire

Completing the CA All Health Services Tuberculosis Screening Questionnaire is an essential step for individuals who have submitted a chest x-ray as proof of their tuberculosis screening. This guide offers a step-by-step approach to help users accurately fill out the questionnaire online.

Follow the steps to complete your tuberculosis screening questionnaire

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your full name in the designated field on the form.
3. Record the date of your positive PPD test in the 'Date (m/d/y) of positive PPD' section, ensuring the format is month/day/year.
4. Provide the date of your last chest x-ray in the 'Date (m/d/y) of last chest x-ray' section, using the same month/day/year format.
5. For each symptom listed, indicate whether you have experienced that symptom for three to four weeks or longer since your last chest x-ray by selecting 'YES' or 'NO'.
6. In the confirmation statement at the bottom of the form, you will need to affirm that the health statement is true and that there is no evidence of pulmonary tuberculosis or contagion.
7. Sign the form where indicated to validate your responses.
8. Finally, enter the date of your signature in the space provided.
9. Once you have completed the form, you can choose to save changes, download, print, or share the document as required.

Get started by filling out your tuberculosis screening questionnaire online today.