TB Screening

Name(Required)
MM slash DD slash YYYY
Have you been exposed to anyone with TB in the last year?(Required)
Have you ever been treated for TB?(Required)
Have you had a persistent cough in the last 6 month??(Required)
Have you had hoarseness in the last 6 month??(Required)
Have you had excessive weight loss in the last 6 month??(Required)
Have you had excessive sweating at night in the last 6 month??(Required)
Have you coughed up blood in the last 6 month??(Required)
Have you had persistent fever in the last 6 month??(Required)
Screening Process
If you answered yes to any of these questions, a nurse with SembraNet will call you to complete your screening process.