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NC Department of Health and Human Services
NC Division of Public Health
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Tuberculosis

Info for Healthcare Providers

Alerts & Hot Topics

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Manuals and Guides

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Forms

  • DHHS:
    • Confidential Communicable Disease Report Form - DHHS 2124 (PDF, 280KB) - Physicians and healthcare providers may use this form to notify the local health department of reportable communicable disease cases.
    • TB Register Card (DHHS 2245) (PDF, 193KB)
    • TB Drug Record (DHHS 1391) (PDF, 90KB / Revised May 2014)
    • TB Epidemiological Record (DHHS 1030) (PDF, 573KB / Revised March 2013)
    • TB Flow Sheet (DHHS 2810) (PDF, 92KB / Revised May 2014)
    • Nursing Record of TB Contacts (DHHS 1662) (PDF, 68KB / Revised March 2014)
    • Record of TB Screening (DHHS 3405) (PDF, 122KB / Revised March 2014)
    • SLPH Mycobacteriology Lab Requisition (DHHS 1247) - Specimens for isolation and identification of all Mycobacterium species (including Mycobacterium tuberculosis complex and other nontuberculous mycobacteria) are accepted from public and private health care providers.
    • Order Form for TB Control Materials (DHHS 2407) (PDF, 72KB / Revised March 2014)
    • TB Biologicals Requisition and Inventory (DHHS 3093) (PDF, 50KB / Revised June 2015)
    • Report of Positive Smear (AFB) and/or Positive Culture of TB (DHHS 3005) (PDF, 88KB / Revised March 2014)
    • Individual Contact Form (DHHS 4097) (PDF, 59KB / Revised March 2014)
  • Other:

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Tools & Websites

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