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TB Testing Declination Form

  1. Napa Fire Department TB Declination Form
    I understand that due to my occupational exposure to aerosol transmissible diseases (ATD), I may be at risk of acquiring Mycobacterium Tuberculosis. I understand that the risk of acquiring Tuberculosis includes a possibility of developing a latent infection that has no signs or symptoms. I have been given the opportunity to receive a TB test for this disease or pathogen at no charge to me. However, I decline this test at this time. If in the future I wish to get the TB test, I can receive the test at no charge to me by contacting the Infection Control Officer and requesting the test. I will also have the opportunity to reconsider during the next annual testing opportunity.
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