Highland Community College

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 hccadmissions@highlandcc.edu prior to start of the semester classes.

List of exempt - low incidence - TB Countries

Albania
American Samoa
Andorra
Antigua and Barbuda
Australia
Austria
Bahamas
Barbados
Belgium
British Virgin Islands
Canada
Chile
Costa Rica
Cuba
Cyprus
Czech Republic
Denmark
Dominica
Fuji
Finland
France
Germany
Greece
Grenada
Hungary
Iceland
Ireland
Italy
Jamaica
Luxembourg
Malta
Nauru
Netherlands
New Zealand
Norway
Saint Kitts and Nevis
St. Lucida
Samoa
Slovakia
Spain
Sweden
Switzerland
Turks and Caicos Islands
United Kingdom of Great Britain and North Ireland
United Virgin Islands
United States of America
Wallis & Futuna Islands

 

 

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