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TB Forms
| Form Number |
Form Name |
| ARPE |
Follow-Up and Treatment for Contacts to Tuberculosis Cases |
| ARPE |
Target Testing and Treatment for Latent Tuberculosis Infection |
| TB-9 |
X-Ray Record Card |
| TB-15 |
Monthly Tuberculin Testing Report |
| TB-18-A |
Drug Order Form |
| TB-18-B |
Drug Inventory Form |
| TB-20 |
Attendance Sheet (Chest Clinic) |
| TB-21-R |
Summary Clinic Activity Sheet (Individual) (Optional) |
| TB-34 |
Individual Tuberculosis Report |
| TB-40 |
Appointment Card |
| TB-50 |
Drug Record |
| TB-60 |
Individual Record of Tuberculin Skin Test |
| TB-61 |
Return for Skin Test Reading Card |
| TB-70 |
"Dear Doctor" Form Letter |
| TB-101 |
Tuberculosis Record (LTBI-Reporting Form) |
| TB-102 |
INH Refusal |
| TB-104 |
TB Risk Assessment |
| TB-104S |
TB Risk Assessment - Spanish |
| TB-105-R |
Nursing History |
| TB-106 |
Consent for Treatment |
| TB-107 |
Treatment Record |
| TB-M-108 |
Retention and Disposal of Tuberculosis Records |
| TB-109 |
Clinical Pathway - Active Cases |
| TB-110 |
Clinical Pathway - LTBI |
| TB-111 |
Tuberculosis Clinic Notes (Optional) |
| TB-112 |
Report of Turberculosis Screening |
| TB-113 |
Free From Infectious Disease Letter |
| TB-M-136 |
Classification of TB Skin Test Reactors |
| TB-1001 |
Contact Sheet |
| TB-1006-R |
Diagnostic Clinic Sheet |
| TB-1007 |
X-Ray Clinic Sheet |
| TB-LTBI |
Cards for COT [Spanish, Creole] |
| Workers Log |
Workers Log |