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AIDS/HIV

Epidemiology

Immunization

Sexually
  Transmitted
  Diseases
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Tuberculosis
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Refugee Health

Tuberculosis (TB) 
Forms

• Anti-tuberculosis Therapy Program
  (DPH 4000 initial request for medication)  
  (PDF, 37 KB)

• Medication Refill Request
  (DPH 4126 "pink sheet") (PDF, 8 KB)

• Follow Up on Therapy
  (DPH 4125 "green sheet") (PDF, 8 KB)

• TB Suspect Case Data Form
  (DPH 42001) (PDF, 25 KB)

• Interjurisdictional Tuberculosis Notification
  (DPH 42010) (PDF, 21 KB)
  
• Interjurisdictional TB Notification - Follow-up
  (DPH 42011) (PDF, 19 KB)

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Last Revised: August 25, 2009