Are you living in San Diego or planning to visit? If so, it is important for you to be aware of the tuberculosis (TB) tests that are available and how they work as part of local healthcare services. This blog post will provide key information on how to obtain a TB test form from your doctor's office, what needs to be filled out before submitting it, and where you can get tested once the form has been completed. No matter if this is your first time needing a TB test form in San Diego or not, this article provides everything needed make the process go smoothly!
| Question | Answer |
|---|---|
| Form Name | San Diego Tb Test Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | TUBERCULOSIS, INTRADERMAL, san diego tuberculin card, san diego district tuberculin card |
San Diego Unified School District
VOLUNTEER TUBERCULIN TEST CARD
LAST NAME
FIRST NAME
INITIAL
DATE OF BIRTH
USUAL VOLUNTEER LOCATION (School)
HOME ADDRESS (NUMBER AND STREET)
CITY
ZIP
PHONE NO.
INTRADERMAL TUBERCULIN TEST - VOLUNTEER
Be sure this certificate is filed with the Volunteer Coordinator at your school.
Failure to comply with this requirement will prevent your continual volunteer service with the District.
CERTIFICATE OF TUBERCULOSIS EXAMINATION
Date of skin test ________________________________________________________
Date read ____________________________Induration ______________________m.m
CERTIFICATE OF TUBERCULOSIS EXAMINATION
I certify that I am a physician and surgeon licensed under Chapter 5 of Division 2 of the Business and Professional Code of the State of California; that I have examined the results of an intradermal tuberculin test and/or an
_______________________________________________ _____________________
_______________________________________________ |
__________________ |
Physician and Surgeon |
Date |
School Nurse |
Date |
NOT VALID IF UNSIGNED BY PHYSICIAN |
|