Hawai‘i State Department of Health


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Registration Form	Description
TB Registration Form (Rev. 5/07)	If you are receiving a TB skin test or chest X-ray at one of the Hawaii State Department of Health TB testing locations, fill out this registration form and bring it with you to save time.
Reporting Form	Description
TB Notifiable Disease Report Form (Rev. 1/09) TB Notifiable Disease Report Instructions (Rev. 1/09) TB Reporting Requirements (Rev. 1/09)	If you are a health care provider or facility reporting a suspected or confirmed TB case, fill out the TB Notifiable Disease Report form and fax to TB Registry at 832-5624.
Risk Assessment Form	Description
Hawaii TB Risk Assessment (Rev. 4/13)	If you are a health care provider, you may administer this form to assess for TB risk.
TB Symptom Screening Form	Description
Hawaii TB Symptom Screening (Rev. 5/13)	If you are a health care provider, this is an example of questions you can ask clients to screen for signs and symptoms of TB disease.

This page last updated: May 21, 2013

Hawaii Tuberculosis Control Program
(Temporarily Moved to Pearl City)
(Scheduled to Move Back to 1700 Lanakila Avenue on 5/28/2013)
2385 Waimano Home Road, Building 4
Pearl City, HI 96782
Phone: (808) 832-5731 Fax: (808) 832-5846
TB Info Line: (808) 832-5738