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Homepage Free Tb Test Form

Form Preview Example

 

 

 

 

 

TUBERCULOSISSKINTESTFORM

Healthcare Professional/Patient Name:

Testing Location:

 

 

 

 

 

 

 

 

 

 

 

Date Placed:

 

 

 

 

 

 

 

 

 

 

 

 

Site:

Right

Left

 

 

 

 

 

 

 

 

Lot #:

 

 

 

 

 

Expiration Date:

 

 

Signature (administered by):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RN

 

MD Other:

 

 

 

Date Read (within 48-72 hours from date placed):

 

 

 

 

 

 

Induration (please note in mm):

 

mm

PPD (Mantoux) Test Result:

 

 

 

Negative

Positive

Signature (results read/reported by):

RN

MD Other:

*In order for this document to be valid/acceptable, all sections of this form must be completed.

Common mistakes

Filling out the Tuberculosis (TB) Test form can seem straightforward, but there are common mistakes that people often make. One frequent error is leaving out critical information. Each section of the form must be completed for it to be considered valid. For instance, omitting the healthcare professional's name or the testing location can lead to delays in processing or even invalidation of the test results.

Another mistake is not adhering to the time frame for reading the test results. The form specifies that results should be read within 48-72 hours from the date placed. If this timeline is not followed, it may affect the accuracy of the induration measurement, leading to potential misinterpretation of the test results.

People often confuse the site of the test placement. The form requires a clear indication of whether the test was placed on the right or left arm. Misidentifying the site can create confusion for healthcare providers when reviewing the results, particularly if there are discrepancies in the documentation.

Another common oversight is neglecting to include the induration measurement. This measurement, noted in millimeters, is crucial for determining whether the test result is positive or negative. Without this detail, the healthcare provider may be unable to make an informed decision regarding the patient's health status.

Lastly, individuals sometimes fail to ensure that the signature fields are properly filled out. The form requires signatures from both the person administering the test and the one reading the results. Missing signatures can render the document incomplete and may require additional steps to rectify the situation.

Dos and Don'ts

When filling out the TB Test form, it is important to follow certain guidelines to ensure accuracy and compliance. Here are six things you should and shouldn't do:

  • Do ensure all sections of the form are completed.
  • Do use clear and legible handwriting when filling out the form.
  • Do double-check the expiration date of the PPD (Mantoux) test.
  • Do confirm the testing location and date are correctly noted.
  • Don't leave any fields blank, as this may invalidate the document.
  • Don't forget to sign the form where required, both for administration and results.

Adhering to these guidelines will help ensure that your TB Test form is processed correctly and efficiently.

Similar forms

  • Vaccination Record: Similar to the Tb Test form, a vaccination record contains essential information about immunizations received. It includes the healthcare professional’s name, the date of administration, and the type of vaccine, ensuring that all relevant details are documented for future reference.
  • Bill of Sale: This legal document serves as proof of a transaction between a buyer and a seller, detailing the sale of personal property. For more information, visit documentonline.org/blank-florida-bill-of-sale/.
  • Medical History Form: This document collects a patient’s past medical history, including previous illnesses, surgeries, and medications. Like the Tb Test form, it requires thorough completion to provide healthcare providers with a comprehensive understanding of the patient’s health.
  • Consent Form: A consent form is used to obtain permission from a patient before a medical procedure or treatment. It shares similarities with the Tb Test form in that it must be signed by both the patient and the administering healthcare professional, ensuring clarity and agreement on the procedure.
  • Patient Intake Form: This form gathers important information about a patient’s demographics, insurance details, and health concerns. Much like the Tb Test form, it requires accurate completion to facilitate effective patient care and record-keeping.
  • Lab Test Requisition Form: A lab test requisition form is used to order laboratory tests. It includes details such as the patient’s information, the type of test requested, and the physician’s signature, paralleling the Tb Test form in its need for comprehensive information and proper authorization.