Tuberculosis (TB) Prevention Forms and Checklists
NKY Health's Safety Manual
- Replaces: Supersedes all previous information on the same topic
- Reviewed: Annually
- Section Revised: Separated from Prevention of Tuberculosis Transmission Plan and Moved to Google Sites 1/1/2022, Revised 1/1/2022
- Contact: Employee Health Nurse and Safety Staff
TB Skin Testing Declination Form
TB Skin Testing Declination Form
Declination of Tuberculosis Skin Test.pdf
Annual TB Risk Assessment Form
Annual TB Risk Assessment Form
TB4 TB Risk Assessment Form.pdf
TB Exposure control Training Record
TB Exposure control Training Record
Tuberculosis Exposure Control Training Record.pdf
OSHA Respirator Medical Evaluation Mandatory Questionnaire
OSHA Respirator Medical Evaluation Mandatory Questionnaire
(This form is Appendix C to CFR 1910.134.)Â
OSHA Questionnaire.pdf