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If yes, when_____________________________________ o ohave you ever been treated with. Cough lasting more than 3 weeks, unexplained? Africa, asia, central america, south america, or. Mantoux tuberculin skin test (tst) or a quantiferon gold test, unless a previous positive test. Information/consent mycobacterium tuberculosis (tb) is a disease which is.
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Yes no if yes was the test positive? I understand the risks and benefits of the tb skin test and request the test be given to me. Yes no yes no yes no yes no yes no yes no yes no yes no yes no yes no high risk regions include: O o ohave you ever had a positive tb.
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Web tuberculosis screening questionnaire form section 1: Cough lasting more than 3 weeks, unexplained? (2) have their sputum collected; Africa, asia, central america, south america, or.
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