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TB Program Forms

Forms

  • TB Contact Investigation Form (pdf) (Optional)

    Please enter the contact investigation data in Orpheus 1) after first round screening 2) after second round screening and 3) after any contacts diagnosed with LTBI have completed their treatment course. Use of the Contact Investigation form is optional (see TB Case Reporting & Data Entry Manual, Part 4: Contact Data Entry).

In State Tra​​nsfers

To transfer cases, contacts, LTBI and B-waivers within the state of Oregon, please see the TB Transfer Instructions.


Transferring TB Cases and Contacts to Other States and U.S. Territories

For complete directions on how to transfer cases out of Oregon to another U.S. state or territory, please see the TB Transfer Instructions. U.S. territories include American Samoa, Federated States of Micronesia, Guam, Northern Mariana Islands, Puerto Rico, Republic of Marshall Islands, Republic of Palau and U.S. Virgin Islands.

International Transfer of TB Cases and Contacts

Attempts should be made to transfer all TB cases and contacts who are leaving the U.S. Review the CDC DTBE's Process for International Notification of TB Cases. Contact heidi.behm@state.or.us if there are questions. A note should be left in Orpheus regarding the international transfer of a case or contact.

Obtaining Medical Records for TB Patients who enter the United States

Information on obtaining international medical records is available at CDC DTBE's Process for International Notification of TB Cases.

TB Cases and Contacts Transferred to Oregon from Other States and U.S. Territories

If a case of TB disease is transferred from another state or country to your jurisdiction, create a new case in Orpheus. When you receive a transfer to your jurisdiction, you must inform the referring jurisdiction about the outcome. Complete and forward the Interjurisdictional TB Notification Follow-Up Form to the referring jurisdiction.



 

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