Get Sutter Health Tuberculosis Screening Questionnaire And Quantiferon Lab Charting 2020

Filling out the Sutter Health Tuberculosis Screening Questionnaire And Quantiferon Lab Charting online is an essential step for ensuring the health and safety of individuals potentially exposed to tuberculosis. This guide provides clear, step-by-step instructions to help users complete the necessary form accurately and efficiently.

Follow the steps to successfully complete your questionnaire online.

1. Click ‘Get Form’ button to access the questionnaire and open it in your preferred document editor.
2. Begin by filling in your last name, first name, and middle initial in the designated fields. Make sure to use black ink if you are printing the form.
3. Next, provide your department, location, phone number, and date of birth in the specified sections.
4. In the questionnaire section, answer the first question regarding your history of a positive TB test. Mark 'Yes' or 'No' accordingly. If applicable, provide the date of your positive TB skin or blood test, alongside the last chest x-ray date if you answered 'Yes'.
5. For the second question, indicate whether you were treated with INH if you answered 'Yes' in step 4.
6. In the next section, answer the following questions concerning symptoms experienced over the past year. For each symptom, select 'Yes' or 'No' as applicable.
7. After completing the questionnaire, confirm that your responses are accurate. Sign the form as a healthcare worker and date it.
8. Once all sections are completed, save your changes. You may also download, print, or share the form as required.
9. Submit the completed form to your local Employee Health division via email or fax as listed in the document.

Complete your Sutter Health Tuberculosis Screening Questionnaire And Quantiferon Lab Charting online today to ensure your health and compliance.