Nurse Choice, Tuberculosis Skin Test Form


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What is a Tuberculosis Skin Test Form?

This form is a simple blank with a table that is filled out when testing for tuberculosis (Mantoux test). Although issued by the NurseChoice agency, the form is free and universal and can be used by any organization that conducts such testing.

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What do I need the tuberculosis skin test form PDF for?

  • This form is used by clinics, hospitals, and other medical organizations to test patients for TB and record results.
  • The skin test for tuberculosis is mandatory if you have had contact with a sick person or have symptoms that indicate the possibility of tuberculosis.
  • Also, this screening should be carried out for children, healthcare workers, tourists from countries where tuberculosis is common, and other groups of people at high risk.

How to Fill Out a Tuberculosis Skin Test Form?

  1. This form is filled in by a healthcare professional who conducts the test and records the results. It can be the same person or two different people.
  2. First, you need to specify the patient's name, the procedure's place, and the date. This first half of the document must be signed by the nurse (or other healthcare workers) who gave the test.
  3. Verification of the result should be done no earlier than 48 hours and no later than 72 hours after the injection. In the second half of the form, indicate the width of a blister at the injection site in millimeters and the measurement date.
  4. The completed form must be attached to the patient's personal records. The attending physician evaluates the result.

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Organizations that work with tuberculosis skin test form

  • hospitals;
  • clinics;
  • health centers.


  • Which vaccination may cause a false positive skin test for tuberculosis?

    The TB vaccine (DCG) can do it. However, much depends on the age at which it was made. Fortunately, modern methods help accurately understand whether the result is false or true positive.

  • What does a positive tuberculosis skin test look like?

    Severe redness and a wide (10 mm and up) papule at the injection site indicate possible infection with tuberculosis or contact with a sick person. The stronger the reaction, the higher the likelihood of the disease.

  • Where to get a tuberculosis skin test?

    The TB test is a fairly simple procedure that many medical institutions carry out. If you need it because you are in the immigration program, contact your local health department to get a referral to the right clinic.

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Fillable online NurseChoice, Tuberculosis Skin Test Form
(4.6 / 5) 94 votes
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