UW HSIP- Subsequent TB Risk Assessment

Please complete a HSIP Annual TB Risk Assessment submit the form for approval.

 Note:

·        Full student name, student number, signature, and date of signature are required.

·        All three questions must be answered.

·        If you indicate "Yes" to one of the questions on the HSIP Annual TB Risk Assessment form, a subsequent tag will be created for you to complete the HSIP Tuberculosis Symptoms Screening (TBSS) form. 

 If you have questions, please contact HSIP at myshots@uw.edu.