Having a solid understanding of South Carolina’s Department of Health and Environmental Control (DHEC) Form 1420 is essential for both businesses and individuals in the Palmetto State. DHEC Form 1420 serves as proof that an individual or business has met the environmental requirements set forth by the state. Complying with these standards not only demonstrates responsible behavior, but it also can save time and money. As such, learning about DHEC Form 1420 and understanding what is required to comply allows people to operate in full compliance with relevant regulations. In this blog post, we will explain everything you need to know about DHEC Form 1420 – covering topics like: why it's important; when/why you need one; how to fill out a form correctly; common mistakes & how to avoid them; updated rules & regulations from 2021, etc.. Read on and learn more!
Question | Answer |
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Form Name | SC DHEC Form 1420 |
Form Length | 2 pages |
Fillable? | Yes |
Fillable fields | 63 |
Avg. time to fill out | 13 min 10 sec |
Other names | dhec tb form, scdhec form 1420 in south carolina, sc dhec tb risk assessment form, dhec form 1420 |
D H E C
Promote Project Prosper
School Employee/Individual Certificate of Evaluation for Tuberculosis
Name: Last |
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M.I. |
Residence Address |
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County |
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Public or private school, kindergarten, nursery or day care center |
Date Employed |
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of current employment |
or other employer or individual |
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TEST RESULTS
DISPOSITION
CERTIFICATION
TUBERCULIN SKIN TEST _______ |
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CHEST |
REMARKS |
Date Given |
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Date: |
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5 TU PPD MANTOUX METHOD |
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Interpretation: |
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_____________mm __________________ |
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Date Interpreted |
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_____ No tuberculosis infection per 5 TU |
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PPD1 |
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_____ Tuberculosis infection, no evidence of disease
–––––Prevention treatment started _________________ and completed __________________________ 1
–––––Prevention treatment started _________________ but not completed __________________________ 2
–––––Prevention treatment not prescribed/refused 2
_____ History of tuberculosis disease Treatment started ________________ and completed
__________________ 1
_____ Current tuberculosis disease
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other employment on _____________________________ 2 |
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1 No further routine screening required |
2Remains at lifelong risk of developing tuberculosis |
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This is to certify that I have examined the school employee named herein for tuberculosis and report my |
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finding as indicated above pursuant to the Code of Laws of South Carolina, 1976, as amended April 24, 1979 |
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This is to certify that I have examined the individual named herein for tuberculosis and report my findings as |
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indicated above. |
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Physician’s Signature |
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Date |
DHEC 1420 (08/1998) DISPOSITION: This form shall be retained in the files of the current employer or individual following evaluation and certification.
SCHOOL EMPLOYEE/INDIVIDUAL CERTIFICATE OF EVALUATION FOR TUBERCULOSIS: this form may be used for school employees or other individuals who need documentation of tuberculosis evaluation. It should be maintained in the current employer’s file for school employees and by employer or individual for other needs.
CODE OF LAWS OF SOUTH CAROLINA, 1976, AS AMENDED APRIL 1979, SECTION
SECTION
SECTION
SUMMARY OF GUIDELINES OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL. (Regulation
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