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Get Sutter Health Tuberculosis Screening Questionnaire And Quantiferon Lab Charting 2020

RST NAME: MIDDLE: Please use black ink DEPARTMENT: LOCATION: PHONE: DOB: / / PLEASE ANSWER QUESTIONS BELOW 1. Yes No Yes No Have you ever had a history of a positive TB Test? Positive TB skin test Date of positive test: Positive TB blood test Date of last chest x-ray:.

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