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Division of Tuberculosis Control, Refugee and Migrant Health


Forms

National Tuberculosis Controllers Association (NTCA) Transfer Forms

NTCA Notification Instructions 

 Maryland Notification Procedures

Interjurisdictional Tuberculosis Notification Form

Interjurisdictional Follow-up Form

International Tuberculosis Notification Form

Refugee Health Form

Maryland Refugee Health Assessment Form

State of Maryland, Tuberculosis Patient/Provider Agreements

[Two (2) copies should be signed. One kept by the patient, and one kept by the provider in the patient’s record.]

[Regarding patient/provider agreements in foreign languages, given the diversity of dialects and cultures for certain languages (e.g., Spanish and French); if a patient reads the agreement and does not understand it, a translator is needed in person or over the telephone, to suitably explain the agreement for the patient. These agreements are not meant to substitute for a translator.]

English Korean
Amharic
(Spoken in Ethiopia)
Spanish
Burmese (spoke widely in Myanmar) Tagalog (Spoken widely in the Philippines)
Chinese - Simplified
(For persons from Mainland China)
Urdu
(Spoken widely in Pakistan)
Creole
(Spoken in Haiti)
Vietnamese
French  
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