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Get and Sign 440 775 8180 or  Form

Get and Sign 440 775 8180 or Form

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Medical Provider Signature Date Part I Tuberculosis TB Screening Questionnaire to be completed by incoming students Please answer the following questions Have you ever had close contact with persons known or suspected to have active TB disease q Yes q No Were you born in or have you lived in one of the countries listed below that have a high incidence of active TB disease If yes please CIRCLE the country below Afghanistan Algeria Angola Argentina Armenia Azerbaijan Bahrain Bangladesh Belarus...
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