* Required Information
TB Screening
Do you currently have any of the following that has lasted three (3) weeks or longer?
Have you ever:
Employer Review

I) If the employee answers yes to any question 1-9, document the objective reason for the symptom. If there is no known reason for the symptom lasting 3 weeks or longer, the employee is to have a TB skin test.

II) If the employee answers yes to any question A-B, the employee is to have a TB skin test.

III) If the employee answers yes to question C, the employee is to have either a chest x-ray or a physician statement noting the employee is free from communicable disease.

Administrative Review