Ppd Test Results Form PDF Details

Are you worried about possible exposure to a communicable disease or other health risks? Are you curious as to how the test results for Ppd tests are delivered and documented? Knowing what the form looks like, understanding its purpose and features can help you feel more comfortable through the entire testing process. In this blog post, we'll look at what information is found on the Ppd Test Results Form, why it's important and how reading your results can provide peace of mind. By better equipping yourself with knowledge of Ppd testing procedure, you can empower yourself to make informed decisions regarding your healthcare.

QuestionAnswer
Form NamePpd Test Results Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesforms for recording tabe test results, mantoux l8 form, online begin test page, printable ppd forms

Form Preview Example

ID LABEL HERE --->

LABORATORY - MANTOUX SKIN TEST RESULT

5TU-PPD-TUBERCULIN

FORM L8

|__| - |__|__| - |__|__|__|__| - |__|

VISIT #:

FORM COMPLETED BY:

___ ___

___ ___ ___

 

 

VERSION DATE: 10/01/99

ANY MISSING OR INCOMPLETE TEST RESULTS MUST BE EXPLAINED ON THIS FORM.

A1. 5TU-PPD-TUBERCULIN WAS:

 

 

DONE

1

(A2)

NOT DONE

2

 

____________________________

 

(END)

(SPECIFY REASON)

 

 

PARTICIPANT REFUSED

3

(END)

A2. DATE 5TU-PPD-TUBERCULIN PLACED:

 

 

/

 

 

 

/

 

 

 

M

 

D

 

 

Y

A3. DATE OF 5TU-PPD-TUBERCULIN READING:

 

 

/

 

 

 

/

 

 

 

M

 

D

 

 

Y

A4. RECORD MEASURED INDURATION OF 5TU-PPD-TUBERCULIN: |___|___|___| mm

NOTE: SERONEGATIVE PARTICIPANTS THAT HAVE A READING BETWEEN 5 MM AND

10 MM OF INDURATION REQUIRE A REFERRAL FOR CLINICAL EVALUATION

AND/OR TREATMENT.

WIHS Laboratory Form L8: Mantoux Skin Test Result - 5TU-PPD-Tuberculin - 10/01/99

Page 1 of 1