Sample Annual Tuberculosis Risk Assessment Worksheet


To meet its requirements for performing an annual tuberculosis risk assessment, Lakeland (Fla.) Surgical & Diagnostic Center documents its compliance by filling out an extensive worksheet.


To download a sample copy of this worksheet you can adapt for use in your ASC, click here (doc).


Learn more about Lakeland Surgical & Diagnostic Center.

Download other sample forms for adaptation and use in your ASC:


- Sample OR/Procedure Room Cleaning Checklist


- Sample General Area Cleaning Checklist


- Sample Incomplete Biological Result Form

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