TB case management tools for LPHAs

IGRAs

• Manufacturers' Instructions for QFT-Plus TB test procedure
• TB QuantiFERON testing guidance at the CDPHE Laboratory

HIV

• HIV/TB testing guidance.

Sputum

• Instructions for collecting sputum for TB.
• Video instructions for collecting sputum.
• Microbiology monitoring tool.
• Sputum collection kit and instructions.

X-rays

• Chest X-ray referral form.

Patient monitoring

• Tuberculin skin test patient intake form.
• TB health assessment and medical history.
• TB infection (LTBI) monthly monitoring tool.
• Visual acuity monitoring.
• Limiting liver toxicity in the HIV-positive patient with TB infection.
• Impact of poor nutrition on TB relapse.
• LiverTox
• HIV/TB Testing Guidance at the CDPHE Laboratory.
• Adverse reaction flashcards (multiple languages).

Contact investigation

• Contact investigation checklist.
• Contact screening form.
• Warning letter for contact evaluation.
• Source case investigation form - pediatric.
• TB contact investigation record.

Treatment tracking tools

• Directly observed therapy log.
• LTBI Consent for directly observed therapy.
• Directly observed preventative therapy log.
• LTBI monthly monitoring form.
• TB isolation order.
• Termination of TB isolation order.
• TB patient treatment contract.
• Directly Observed Therapy Consent Form | Spanish

Video DOT

• VDOT/EDOT clinical protocol| Spanish
• VDOT/EDOT guidance
• VDOT instructional video | with Spanish subtitles
• VDOT Placement
• Adverse reaction flashcards (multiple languages)

Epitrax

• Guide for Tuberculosis Evaluation Work in EpiTrax
• Epitrax job aids

Medical orders and patient contracts

• Letter ordering treatment for active TB.
• TB treatment agreement.
• Consent to release private health information.
• TB patient warning letter for refusing treatment for active TB.
• Declination of TB infection (LTBI) treatment.
• Completion of treatment notification.​​​
• Contact us for forms in Spanish, Karen, Burmese, Nepali, Somali and Vietnamese.

• Guidelines for using these forms
• Directly Observed Therapy Consent Form | Spanish

Contact