Tuberculosis Screening Questionnaire
Tuberculosis (TB) is a bacterial infection that attacks the lungs and sometimes other parts of the body. An individual with active tuberculosis can spread the disease by coughing, sneezing, speaking, laughing and singing; distributing the bacteria in the air to be inhaled by individuals in close proximity.
Highland Community College requires all students enrolled and entering classrooms to complete a tuberculin screening questionnaire. Fill out and submit this form no later than registration day to prevent a drop placed on pre-registered classes.
If the answers to the above questions are "NO" ---- no further testing or action is required.
If the answer is "YES" to ANY of the above questions, Highland Community College requires a health care provider to complete a tuberculosis assessment, which includes TB testing. This assessment may be obtained at the local Health Department or physician/health clinic. A hold will be placed on your attendance to all classes until this has been provided. Return form to HCC Admissions, 606 West Main, Highland, KS 66035, or fax to 785.442.6106, or email to firstname.lastname@example.org prior to start of the semester classes.
List of exempt - low incidence - TB Countries
Antigua and Barbuda
British Virgin Islands
Saint Kitts and Nevis
Turks and Caicos Islands
United Kingdom of Great Britain and North Ireland
United Virgin Islands
United States of America
Wallis & Futuna Islands