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