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How to fill out the TN MH-5426 online
The TN MH-5426 is an essential form used for tuberculosis symptom screening in various facilities. This guide provides a clear, step-by-step approach to filling out the form online, ensuring a smooth and efficient process for users.
Follow the steps to successfully complete the TN MH-5426 online.
- Press the ‘Get Form’ button to access the TN MH-5426 form and open it in the editor.
- Begin by filling in your name, including last name, first name, and middle initial in the designated fields.
- Enter your date of birth in the format MM/DD/YYYY.
- If applicable, provide any aliases in the specified space.
- Indicate your country of origin in the relevant field.
- Specify the facility name where the screening is being conducted.
- Select the program type by checking the appropriate box for residential, non-residential, or personnel.
- For Section I, respond to each symptom regarding TB by circling Y for yes or N for no.
- In Section II, indicate if there is a documented history of a previous positive TB skin test and provide the necessary details, including date and result.
- Complete the section regarding previous negative TB skin tests in the past 12 months if applicable.
- For Section III, circle the action taken based on the responses in Section I and II.
- Finally, enter your signature and title in the designated areas and date the form.
- Once all sections are completed, save your changes, and you will have the option to download, print, or share the TN MH-5426 form.
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