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TRUCTIONS: Tuberculosis (TB) screening must be performed by a licensed health care provider whose legally authorized scope of practice allows him/her to conduct medical examinations and/or the Mantoux TB Skin Test (TST) in accordance with the recommendations of the Centers for Disease Control and Prevention to determine if a person has TB infection or disease. EMPLOYEE ( Complete the following section - type or print clearly) EMPLOYEE INFORMATION 1 PRINT OR TYPE EMPLOYEE S FULL NAME (AS IT A.

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At time of reading: Name and signature of person reading test. Date and time test read. Exact number of mm of induration (if no induration, document "0" mm) Interpretation of reading (i.e., positive or negative, based on individual's risk factors)

Annual TB testing using an IGRA or TST is not routinely recommended. Health care facilities should perform TB testing and complete a signs and symptoms assessment after known or ongoing exposure to TB or complete a signs and symptoms assessment annually for HCP with untreated TB infection.

The TB skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin on the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.

A repeat TB test (e.g., TB blood test or a TB skin test) is not required. Annual TB testing of health care personnel is not recommended unless there is a known exposure or ongoing transmission at a healthcare facility. Health care personnel with untreated latent TB infection should receive an annual TB symptom screen.

If you have a negative skin test, you need a repeat test at least once every four years. If you have a documented positive skin test, you must have an initial chest X-ray. After that, you still need to be screened every four years.

Who may administer the TB risk assessment? Per California Education and Health and Safety Codes, the TB risk assessment is to be administered by a health care provider. The risk assessment should be administered face-to-face.

If the result of the x-ray is not clear you may also be asked to give a sputum sample (phlegm coughed up from your lungs). If your test shows that you do not have TB , you'll be given a certificate which is valid for 6 months from the date of your x-ray.

You'll be given a chest x-ray to test for TB . If the result of the x-ray is not clear you may also be asked to give a sputum sample (phlegm coughed up from your lungs). If your test shows that you do not have TB , you'll be given a certificate which is valid for 6 months from the date of your x-ray.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232