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  • Missouri Tb Risk Assessment Form

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E address telephone number a. Please ansWer tHe FolloWinG Questions (sections a & b to be comPleteD bY Patient) have You ever had a positive mantouX tuberculin sKin teXt (tst)? have You ever been vaccinated with bcg? have You ever had a positive gamma release assaY (igra) test? have You ever been diagnosed with or treated for tb disease? Yes Yes no no b. tb risk assessment have You ever had close contact with anYone who was sicK with tuberculosis? Yes no Yes Yes Yes colo.

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Repeat risk assessments should occur every four years (unless otherwise required) to identify any additional risk factors, and TB testing based on the results of the TB risk assessment. Re- testing should only be done in persons who previously tested negative, and have new risk factors since the last assessment.

The purpose of this tool is to identify adults with infectious tuberculosis (TB) to prevent them from spreading disease. •

To bill for placing the purified protein derivative (PPD) skin test for tuberculosis, use CPT®code 86580.

The first page, the Connecticut Tuberculosis (TB) Risk Assessment, is an assessment tool that may be used to identify asymptomatic adults and children for latent TB infection (LTBI) testing.

The risk assessment should be administered at least once. Persons can be screened for new risk factors at subsequent preventive health visits. Because IGRA has increased specificity for TB infection in persons vaccinated with BCG, IGRA is preferred over the TST in these persons.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232