Printable blank TB Test Result Form

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TB Test or PPD Skin Test (also referred to as the tuberculin, Mantoux, or the Tuberculosis Test) is used to determine if a person has a silent (or latent) tuberculosis infection in their lungs. The Tuberculosis Test is often used by healthcare providers in lieu of the standard blood tests for TB. Usually, this test is used in children who are under five.

What You Need TB Test Form For

TB Skin Test Form is used to document the results of the tuberculin skin test. Many people in the US who are infected with TB-causing bacteria do not show any active symptoms of this dangerous disease. Therefore, they need blank TB Test form (and i.e. PPD Skin Test form), especially if they:

  • Have interacted with someone with TB;
  • Work at a hospital;
  • Have weak immunity as a result of taking certain meds or being exposed to certain diseases.

How to Fill out the PPD Skin Test Form

It should be stressed that the PPD Test forms or TB Test Result Forms are filled out by your healthcare provider in several steps. The upper section of the document needs to be filled out upon making the injection. The lower section is to be completed when the results of the tuberculin test are ready (usually within up to 72 hours after the procedure).

Aside from the details on your PPD skin test results, the form should include the following information:

  • Your and your doctor’s names.
  • Location of the healthcare facility where the test was administered;
  • Expiration date;
  • Date when the test was done;
  • Date when the results were read;
  • Your doctor’s signature.

How is the tuberculin skin test administered?

The skin test is usually performed by a health professional. To help reduce the pain of the injection, the skin of the forearm is cleansed before the TB skin test is performed. The injection is given in a single spot in the middle of the forearm.

Tuberculin skin test usually takes about 10 to 15 minutes. You may be asked to wait for a few minutes after the injection before returning to your normal activities.

Organizations that Work with the Mantoux Skin Test Form

  • School administrations
  • Military facilities
  • Healthcare facilities, etc.

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