| Form Number |
Form Name |
| ARPE |
Follow-Up and Treatment for Contacts to Tuberculosis Cases |
| ARPE |
Target Testing and Treatment for Latent Tuberculosis Infection |
| DOT Invoice |
DOT Invoice Template |
| TB-9 |
X-Ray Record Card |
| TB-15 |
Monthly Tuberculin Testing Report (rev. 3/2013) |
| TB-18-A |
Drug Order Form (rev. 4/2013) |
| TB-18-B |
Drug Inventory Form (rev. 4/2013) |
| TB-20 |
Attendance Sheet - Chest Clinic (rev. 2/2013) |
| TB-21 |
Summary Clinic Activity Sheet (Individual - Optional) |
| TB-34 |
Individual Tuberculosis Report |
| TB-34 |
Individual Tuberculosis Report (MS Excel) |
| TB-40 |
Appointment Card |
| TB-50 |
Drug Record |
| TB-60 |
Individual Record of Tuberculin Skin Test (rev. 10/2012) |
| TB-61 |
Return for Skin Test Reading Card |
| TB-101 |
Tuberculosis Record (LTBI-Reporting Form, rev. 3/2013) |
| TB-101 |
Tuberculosis Record (LTBI-Reporting Form / MS Word, rev. 3/2013) |
| TB-102 |
Refusal of Treatment Form (rev. 2/2013) |
| TB-104 |
TB Risk Assessment |
| TB-104S |
TB Risk Assessment - Spanish |
| TB-105 |
Nursing History (rev. 2/2013) |
| TB-106 |
Consent for Treatment (rev. 2/2013) |
| TB-107 |
DOT Treatment Record (rev. 2/2013) |
| TB-109 |
Active or Suspect Pathway (rev. 3/2013) |
| TB-110 |
LTBI Pathway (rev. 3/2013) |
| TB-111 |
Tuberculosis Clinic Notes (Optional) |
| TB-112 |
Report of Tuberculosis Screening |
| TB-113 |
Free of TB Letter (rev. 3/2013) |
| TB-115 |
Smear Culture Log (rev. 3/2013) |
| TB-1001 |
Contact Sheet |
| TB-1006 |
Diagnostic Clinic Sheet (rev. 2/2013) |
| TB-1007 |
X-Ray Clinic Record (rev. 2/2013) |
| TB-150 |
Workers Log (rev. 2/2013) |