Los Angeles Unified School District TB Compliance
This file contains important information regarding tuberculosis compliance for employees of the Los Angeles Unified School District. It includes risk assessment guidelines and instructions for documentation. Ensure that all fields are completed as instructed to maintain compliance.
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How do I fill this out?
Filling out this form is crucial for compliance with health guidelines. Begin by gathering all necessary personal information and health history. Follow each section carefully to ensure accurate completion.
How to fill out the Los Angeles Unified School District TB Compliance?
1
Gather personal information including name and date of birth.
2
Check relevant boxes regarding tuberculosis risk factors.
3
Note the results of any previous TB tests or treatments.
4
Obtain the signature and information of a licensed health care provider.
5
Submit the completed form to the designated LAUSD office.
Who needs the Los Angeles Unified School District TB Compliance?
1
New employees at LAUSD must submit this form for health compliance.
2
Current employees needing TB clearance for job requirements.
3
Health care providers administering TB tests and assessments.
4
Students or volunteers who may be in contact with vulnerable populations.
5
Anyone returning from travel to areas with high TB incidence.
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What are the instructions for submitting this form?
Complete the form fully and obtain an appropriate signature from a licensed healthcare provider. Return the original completed form to LAUSD Employee Health Services at 333 S. Beaudry Avenue, 14-110, Los Angeles, CA 90017. If you prefer, you may also fax it to (213) 241-8918 or email it at employeehealth@lausd.net.
What are the important dates for this form in 2024 and 2025?
For 2024, ensure that your TB tests and x-ray results are current prior to applicable deadlines. In 2025, keep an eye on yearly compliance renewal dates and any updates from the LAUSD regarding health policies.
What is the purpose of this form?
The purpose of this form is to assess the tuberculosis risk for employees in the Los Angeles Unified School District. It ensures that proper health measures are in place to promote safety and well-being. This form is pivotal in preventing the spread of TB within the school community.
Tell me about this form and its components and fields line-by-line.
- 1. Name: Full name of the employee.
- 2. Date of Birth: Employee's date of birth.
- 3. Job Title: Current job title within LAUSD.
- 4. Phone: Contact phone number.
- 5. Social Security No: Social security number or employee number for identification.
- 6. Email Address: Email address for communication.
- 7. TB Risk Factors: Check boxes related to TB risk assessment.
- 8. Testing Results: Details of previous TB tests and results.
- 9. Healthcare Provider Signature: Signature of the examining healthcare professional.
What happens if I fail to submit this form?
Failing to submit this form may result in non-compliance with health regulations, potentially affecting your employment status. It could also result in additional health screenings or delays in hiring.
- Compliance Issues: Non-compliance may lead to disciplinary actions from LAUSD.
- Health Risk: Unscreened employees may inadvertently spread TB.
- Employment Delays: Failure to submit on time may delay your onboarding process.
How do I know when to use this form?
- 1. Hiring Procedure: Required to complete during the pre-employment procedure.
- 2. Health Status Changes: Must be resubmitted if there are updates in health status.
- 3. Travel Requirements: Needed after travel to TB prevalent regions.
Frequently Asked Questions
How do I start filling out the TB compliance form?
Begin by gathering your personal information and health history.
Is there a time limit for tuberculosis testing?
Yes, TB testing must be done within 60 days prior to hiring.
Can I edit the PDF after downloading?
Yes, you can edit it using our PrintFriendly PDF editor.
What should I do if I have a positive TB test?
Consult a licensed health care provider for further evaluation.
Do I need to resubmit the form after a negative TB test?
No, unless new risk factors arise.
How do I ensure compliance with the TB regulations?
Follow the guidelines provided in the form completely.
What contact information should I include?
Include your phone number and email address.
Do I need to submit the form immediately after filling it out?
Yes, submit it as soon as it is completed to avoid delays.
Where can I find additional information on TB?
Refer to the health department's website specified in the form.
Who can assist me with filling out this form?
A licensed health care provider can guide you through the process.
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