Agencies
Services
Tuberculosis (TB) Forms
- Active Tuberculosis Treatment Plan
- Active Tuberculosis Treatment Plan (Espanol)
- Consent Treatment Plan for Tuberculosis Infection
- Consent Treatment Plan for Tuberculosis Infection (Espanol)
- Corrections Tuberculosis Risk Assessment
- Corrections Tuberculosis Risk Assessment (Espanol)
- Directly Observed Therapy Agreement
- Directly Observed Therapy Agreement (Espanol)
- Follow-Up Report on Patient with Active TB
- Follow-Up Report on Patient with Active TB (Espanol)
- HIPAA Consent (Burmese)
- HIPAA Consent (Karen)
- Initial Report on Patient with Tuberculosis
- Initial Report on Patient with Tuberculosis (Espanol)
- Interjurisdictional Tuberculosis Notification for Latent Infection
- Interjurisdictional Tuberculosis Notification for Latent Infection (Espanol)
- International Tuberculosis Notification
- International Tuberculosis Notification (Espanol)
- Mycobacteriology Laboratory Submission Form
- New Tuberculosis Suspect Referral
- New Tuberculosis Suspect Referral (Espanol)
- Patient Tuberculosis Checklist
- Patient Tuberculosis Checklist (Espanol)
- Pediatric Tuberculosis Risk Assessment
- Pediatric Tuberculosis Risk Assessment (Espanol)
- Refusal of Care for Tuberculosis
- Refusal of Care for Tuberculosis (Espanol)
- Report of Tuberculosis Screening
- Report of Tuberculosis Screening (Espanol)
- Treatment of Active Tuberculosis Education Form
- Treatment of Active Tuberculosis Education Form (Espanol)
- Tuberculosis Epidemiological Worksheet
- Tuberculosis Epidemiological Worksheet (Espanol)
- Tuberculosis Infection Treatment Plan
- Tuberculosis Infection Treatment Plan (Espanol)
- Tuberculosis Medical Case Review
- Tuberculosis Medical Case Review (Espanol)
- Tuberculosis Medication Consent (Burmese)
- Tuberculosis Medication Consent (Karen)
- Tuberculosis Registration Form (Burmese)
- Tuberculosis Registration Form (Karen)
- Tuberculosis Risk Assessment
- Tuberculosis Risk Assessment (Espanol)
- Tuberculosis Symptom Screen
- Tuberculosis Symptom Screen (Espanol)
- Tuberculosis Testing Declination Form (Burmese)
- Tuberculosis Testing Declination Form (Karen)
- Tuberculosis Treatment Waiver
- Tuberculosis Treatment Waiver (Espanol)
- VDOT User Request Form
- VDOT Treatment Consent Form