OHS​​​​​​​ ► TB Surveillance Form

Please fill out the demographic, TB history, and symptom review areas before you come in and we will take care of the rest for you.

Click, print and complete this form ahead of your scheduled appointment to expedite the check-in time/process

► TB Surveillance Form (PDF Fillable)

► TB Surveillance Form (Blank)

Last updated October 25, 2023