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This form may be completed online at https://hssi.tn.gov ...
For a positive interferon-gamma release assay (IGRA) for (latent) Tuberculosis Infection (TBI), attach a copy of the lab result to this form. For a positive tuberculin skin test (TST) for any child or adolescent < 18 years of age, document the TST result in millimeters (mm) of
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