Medical Records

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Bacteriology Flow Sheet, updated 6/2011

Clinician Progress Notes #1

Clinician Progress Notes #2

TB Contact Investigation Form, TB 502, updated 7/2011

DOT Agreement

DOT Log (Sample)

Guidelines for Using the TB Medical Record and Completing the Forms

Medication List, updated 6/2011

Vision and Hearing Monitoring

Patient Isolation Instructions

TB Clinic Record (Sample)

TB and Health Assessment/History

TB Intake Sheet

Monthly Clinical Assessment

• Case/Suspect
• LTBI | (Sample)
• Joint | (Sample)
• LTBI - Landscape (9 month version)

TB Service Plans

• Master [MS Word]
• Case/Suspect [MS Word]
• LTBI [MS Word]
• Contact [MS Word]