Requirements for Proof of TB Clearance

You may meet the TB Skin Test requirements by one of the following 3 ways:

1. Skin Test

•     May be completed at the medical provider of your choice at your expense. •     St. Agnes Occupational Health Center can provide this skin test for $25.00.
•	If you are a current student at a college, please check with your college’s health center as the cost of this test may be covered by any health fees that you pay as part of your tuition.

2. Chest X-Ray

•	If you have a positive skin test result you will need to have a chest x-ray completed to provide proof of being free from TB. A note providing clearance from a doctor is required. (Please do not bring in x-ray.)
•	 You may have this x-ray completed by any medical provider at your own expense. St. Agnes Occupational Health Centers will complete the x-ray for $40.00.

3. Adult TB Risk Assessment Questionnaire (Not available to preschool employees)

•	This form can be completed by your own medical provider as well as by a St. Agnes Occupational Health doctor at your expense.
•	Clovis Unified School District will provide the services of a school nurse to complete and review this form at no cost to you during the school year. A link to this digital form was provided by your HR Specialist. Once you have completed the top section of the form with your personal contact information, you will need to sign it and submit it to the appropriate School Nurse. Once the School Nurse receives the form, s/he will contact you at the number you provided on the form to review the questions on the assessment with you. She will then submit the completed document to HR. If any additional steps are needed on your part, you will be contacted with additional instructions.
•	Risk Assessment Questionnaires can also be completed and reviewed at the District Office on specified days. Please ask for a list of current dates.

11.2020