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Annual TB screening

A short yearly health check required by policy 05.003. It takes about a minute. Your answers are kept with your personnel records, not shared with the team.

Your name

Your supervisor

Screening date

In the past 12 months, have you had any of these?

A cough lasting 3 weeks or longer

No Yes

Fever without a known cause

No Yes

Night sweats

No Yes

Weight loss you can’t explain

No Yes

Coughing up blood

No Yes

Close contact with someone who has active TB

No Yes

Anything else? (optional)

If you answer yes to anything, your supervisor will follow up privately about next steps, like a TB test. Answering yes doesn’t mean you have TB.

Screening submitted.

Thank you. It’s been added to your training record. If anything needs a follow-up, your supervisor will reach out.

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