
To central office ID# (Last) (First) Street Apt# DOB (Middle) ( City County Zip Code Facility/Care Provider Name Initial Reporting Source Health Dept Private Physician Public Hospital VA Hospital Other (Specify) Military Hospital TDCJ Notice of Arrival of Alien with TB Class A B1 Country of Birth g B2 Preferred Language RACE (check all that apply) White Native Hawaiian or Pacific Islander Black or American In.
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How to fill out the TX TB-400A online
The TX TB-400A is a crucial document used to report cases and patient services related to tuberculosis. This guide will help users navigate the process of filling out the form online, ensuring accurate and thorough submission.
Follow the steps to complete the TX TB-400A successfully.
- Click the ‘Get Form’ button to obtain the TX TB-400A form and open it in your preferred editor.
- Begin by filling in the personal details. Include the patient’s name, date of birth, address, and Medicaid number if applicable. Be sure to check that all information is entered accurately.
- Indicate the report type by selecting if this is an initial report, an address change, or another change. Ensure you provide the date the form is sent to the health department and the central office.
- In the next section, specify the facility or care provider’s name and the initial reporting source. Select one of the following options: health department, private physician, public hospital, VA hospital, military hospital, or TDCJ.
- Continue with demographic information, including country of birth, preferred language, and race. Be sure to check all applicable boxes.
- Provide health-related details. Indicate if the patient has tested positive for TB and include their HIV test results. Document any medical risks associated with the patient, such as chronic renal failure or diabetes.
- Complete the treatment information if this is for latent TB infection only. Specify the Directly Observed Therapy (DOPT) frequency and location.
- Fill in the closure section, indicating the reason for patient follow-up, such as being lost to follow-up, causes of death, or if the patient chose to stop treatment.
- Finally, review all the information entered for accuracy, then save, download, or print the completed form as necessary.
Complete your TX TB-400A online efficiently by following these steps.
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Get answers to your most pressing questions about US Legal Forms API.
Is TB testing required in Texas?
In general, Texas Department of State Health Services does not recommend that low risk individuals be tested for tuberculosis. If a test is needed or recommended, the general public may ask their primary care provider, local clinics, or pharmacies, among other sites.
What does the Texas Department of State Health Services do?
The Texas Department of State Health Services (DSHS) has been restructured to sharpen our focus on public health. Our job is to promote and protect the health of people, and the communities where they live, learn, work, worship, and play.
What is the TB policy in Texas?
It is required by the state of Texas that individuals deemed cases of Tuberculosis disease must be reported within one business day to the local health authority. Reporting patients with Latent Tuberculosis infection to the local health authority is also required and must be done within one business week.
How long do you have to be off work with TB?
If you're diagnosed with pulmonary TB, you'll be contagious for about 2 to 3 weeks into your course of treatment. You will not usually need to be isolated during this time, but it's important to take some basic precautions to stop the infection spreading to your family and friends.
How long is a negative TB test good for in Texas?
(v) Employees with a history of negative skin tests who are close contacts to a known or suspected case of TB shall be skin tested after exposure. If the test is still negative, they shall be retested 90 days after break in contact with the known or suspected case of TB occurs.
How do I contact the Texas Department of State Health Services?
Get in Touch With DSHS By phone: 1-888-963-7111. Online at the DSHS website.
What is a TB conversion?
Tuberculin skin test conversion was defined as the change of tuberculin skin test from negative (<10 mm) to positive (≥10 mm) after 48 –72 h of inoculation.
Can I still go to work if I have TB?
If you have been diagnosed with TB you may be worried that you will have to take time off work and that you will lose money, or even your job. TB can be a serious illness, but if you are well enough to work, and are not infectious, then your employer cannot force you to stay at home.
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