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TB Prevention and Control Saskatchewan
Forms

Please note documents are available in PDF format only.  If you have any difficulty opening any documents please call 1-866-780-6482.

Consent to Receive Medication at School [PDF] May 10, 2013
REVISED: Form to obtain consent to administer TB medications when child is at school.

Medication Record [PDF] July 23, 2019

TB Medication Record: A Quick Guide for Health-care Providers [PDF] July 24, 2019

Nursing Assessment of Visual Acuity and Colour Discrimination [PDF] April 26, 2021

Tuberculin Screening Form for Targeted Pediatric Screening {PDF} July 19, 2017

Note This form can be printed and completed manually.

Tuberculin Skin Test Card {PDF} January 25, 2016
Patient record of TST result (10 cards per 8 1/2 x 11 sheet)
Note: May be ordered from TB Prevention and Control SK.

Tuberculin Skin Test Screening Record {PDF} October 25, 2015
Form for documenting and reporting tuberculin skin test results to TB Prevention and Control SK.
     Quick guide for completing the form [pdf] January 31, 2016

Tuberculosis Referral Form [PDF] June 27, 2021

Note: Form to be used by medical practitioners when referring patients/clients to TB Prevention and Control Saskatchewan. Complete the form and fax to the nearest office. Think Your Patient has TB? A Guide for Healthcare Providers - Click here.

Last Modified: Thursday, January 19, 2023 |
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