Get University Of California Berkeley Tuberculosis (tb) Health Assessment Form
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How to fill out the University of California Berkeley Tuberculosis (TB) Health Assessment Form online
Completing the University of California Berkeley Tuberculosis (TB) Health Assessment Form is a critical step for students prior to enrolling in classes. This guide provides clear instructions to help users fill out the form accurately and efficiently online.
Follow the steps to complete the TB health assessment form online.
- Press the ‘Get Form’ button to access the TB Health Assessment Form and open it in your preferred editor.
- Begin by entering the student’s name and date of birth in the specified fields. Ensure accuracy, as this information will be crucial for identification.
- Input the Student Identification Number (SID#) in the provided field. This number is essential for processing the form.
- Answer all the history questions thoroughly. Indicate any prior BCG vaccinations, positive TB skin tests, risk factors, and signs/symptoms of active TB. Each question must be addressed with either 'Yes' or 'No.'
- If there is a history of latent tuberculosis infection, note the relevant information in the medications section, including start and end dates.
- Complete the testing section by selecting the appropriate tests conducted within the past 12 months. Fill in the date, results, and interpretation for each test as required.
- If a chest X-ray was performed, provide the date and results, making sure to indicate if it is normal or abnormal. Attach the written radiology report as instructed.
- For any abnormalities noted in the chest X-ray, include sputum results and the corresponding dates for the tests completed.
- Finally, the form must be certified by a licensed healthcare provider. Include their name, credentials, signature, address, and office phone number, along with the date of certification.
- Once all fields are filled out correctly, save the changes you made. You may download, print, or share the completed form as needed.
Complete the University of California Berkeley Tuberculosis (TB) Health Assessment Form online today to ensure your enrollment process is smooth.
To check your TB report, you should first contact the facility where you completed your assessment. Many locations provide online access to results, especially if you completed the University of California Berkeley Tuberculosis (TB) Health Assessment Form digitally. Be sure to have your identification handy when inquiring about your report. Your health provider is there to assist you with any questions or concerns.
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