The CDC’s TB risk assessment form is a short yes-or-no checklist you complete at hire as part of baseline tuberculosis screening for healthcare personnel. Read each risk-factor statement, mark yes or no, sign and date the bottom, and return it to whoever requested it — usually your employer’s occupational health department or human resources office. If any answer is “yes,” you are considered at increased risk for TB and your provider will order a blood test or skin test as the next step.1Centers for Disease Control and Prevention. Health Care Personnel Baseline Individual Tuberculosis Risk Assessment
Where to Get the Form
The CDC publishes the “Health Care Personnel Baseline Individual Tuberculosis Risk Assessment” as a downloadable PDF on its website.1Centers for Disease Control and Prevention. Health Care Personnel Baseline Individual Tuberculosis Risk Assessment Most healthcare employers hand it to you during onboarding alongside other preplacement paperwork. Your primary care provider or occupational health clinic can also give you a copy.
One clarification before you start. The CDC also publishes a separate facility-level TB risk assessment worksheet for infection control administrators evaluating a whole workplace. That is a different document. The one individual workers fill out is the baseline individual assessment.
Who Should Complete It
Every healthcare worker in the United States should complete the individual risk assessment upon hire, regardless of job title or clinical role.2Centers for Disease Control and Prevention. Baseline Tuberculosis Screening and Testing for Health Care Personnel The CDC’s screening guidance covers anyone working or volunteering in healthcare settings, including staff at medical facilities inside correctional institutions.3Centers for Disease Control and Prevention. Clinical Testing Guidance for Tuberculosis: Health Care Personnel
Schools, universities, and other non-healthcare employers sometimes use their own TB risk questionnaires modeled on the CDC form. Those requirements come from state and local health departments rather than a federal mandate, and the CDC notes that its recommendations do not override state regulations.3Centers for Disease Control and Prevention. Clinical Testing Guidance for Tuberculosis: Health Care Personnel If a school or non-healthcare employer gave you a form, ask that institution about its submission instructions and deadlines.
What the Form Asks
The assessment is a checklist. You mark each statement that applies to you, and any single “yes” flags you for diagnostic testing.1Centers for Disease Control and Prevention. Health Care Personnel Baseline Individual Tuberculosis Risk Assessment The risk factors fall into a few categories:
- Time spent in countries where TB is common, including parts of Asia, Africa, and Latin America. The form focuses on whether you were born in or have frequently traveled to these areas.4Centers for Disease Control and Prevention. TB Risk and People Born in or Who Travel to Places Where TB Is Common
- Close contact with someone who had infectious tuberculosis — living with, working near, or spending prolonged time in confined spaces with that person.
- A weakened immune system from conditions or medications such as HIV infection or immunosuppressive therapy.2Centers for Disease Control and Prevention. Baseline Tuberculosis Screening and Testing for Health Care Personnel
- A prior positive TB test, or current symptoms including a persistent cough lasting three weeks or longer, chest pain, unexplained weight loss, fever, or night sweats.5Centers for Disease Control and Prevention. Signs and Symptoms of Tuberculosis
Before you sit down with the form, pull up your travel history and any past TB test results. If you have ever received the Bacille Calmette-Guérin (BCG) vaccine, note that too. It will not change how you answer the risk assessment, but it affects which diagnostic test your provider should order afterward.
Filling Out and Submitting the Form
Read each risk-factor statement and check yes or no. Do not leave any item blank. An incomplete form can delay your hiring clearance or enrollment approval.
If you are unsure about a travel date or a past test result, err on the side of checking yes. A false negative on the risk assessment could mean skipping a test you actually need, while a “yes” answer simply triggers a quick blood draw or skin test.
Sign and date the form. Return it to whoever requested it — typically your employer’s occupational health department, human resources office, or the school registrar. The healthcare provider reviewing the form will use your answers to decide whether diagnostic testing is warranted. If every answer is “no” and you have no symptoms, some employers document that result and consider your baseline screening complete without ordering a test, depending on facility policy and any applicable state requirements.
What Happens After You Submit
If your assessment flags any “yes” answers, your provider will order one of two diagnostic tests to check whether you have been infected with TB bacteria.6Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Tuberculosis
TB Blood Test (IGRA)
The interferon-gamma release assay is a single blood draw, usually processed in a lab with results available within 24 to 48 hours. The CDC encourages providers to use this test, and it is the preferred option for anyone who has received the BCG vaccine. BCG can cause a false positive on the skin test, but it does not interfere with the blood test.7Centers for Disease Control and Prevention. Clinical Testing Guidance for Tuberculosis: Interferon Gamma Release Assay It is also the better choice if you might not be able to return for a follow-up reading appointment.
TB Skin Test (TST)
A healthcare worker injects a small amount of purified protein derivative just under the skin of your inner forearm, producing a small raised bump. You must return 48 to 72 hours later so a trained reader can measure any firm swelling (induration) at the injection site. If you do not return within 72 hours, the test is invalid and must be repeated. The reader measures the diameter of the induration in millimeters. Redness alone does not count as a positive result.8Centers for Disease Control and Prevention. Clinical Testing Guidance for Tuberculosis: Tuberculin Skin Test
If Your Test Is Positive
A positive TB test means your body has been infected with TB bacteria. It does not mean you have active disease. The next step is a chest X-ray to look for lung abnormalities. A normal chest X-ray paired with no symptoms generally rules out active pulmonary TB.9Centers for Disease Control and Prevention. Clinical and Laboratory Diagnosis for Tuberculosis If the X-ray shows something concerning, or if you have symptoms such as a persistent cough, chest pain, coughing up blood, fever, night sweats, or unexplained weight loss, your provider will collect sputum samples for laboratory analysis to check for active TB disease.5Centers for Disease Control and Prevention. Signs and Symptoms of Tuberculosis
If your infection is latent rather than active, your provider will discuss antibiotic treatment options with you. Most employers that require the initial screening will also require documentation that you have started or completed treatment before issuing medical clearance.
Cost and Insurance Coverage
What you pay depends on who is requiring the test and what insurance you carry.
When TB testing is a condition of employment in a covered healthcare workplace, OSHA’s position is that the employer must offer the test at no cost to the employee. This applies to all potentially exposed current employees and new hires prior to exposure. If your facility has never encountered or treated anyone with suspected or confirmed infectious TB, there may be no occupational exposure triggering the testing obligation.10Occupational Safety and Health Administration. The Bloodborne Pathogen Standard and the Enforcement Procedures for TB
Under the Affordable Care Act, TB screening for high-risk adults is classified as a covered preventive service. Marketplace plans and many other health plans must cover it with no copayment, coinsurance, or deductible when you use an in-network provider.11HealthCare.gov. Preventive Care Benefits for Adults Zero cost is not guaranteed in every situation. Out-of-network providers and certain plan types may handle it differently.
Without insurance or employer coverage, a TB skin test typically runs between $40 and $90, while an IGRA blood test ranges from roughly $100 to $350. Prices vary by location and provider, so call ahead for a quote if you are paying cash.
Privacy of Your Screening Results
TB screening results are protected health information under HIPAA. Your healthcare provider cannot share your results with your employer without your written authorization. That authorization must specify what information will be disclosed, who receives it, the purpose, and an expiration date, and you can revoke it in writing at any time. Most employers ask you to sign this release as part of onboarding so occupational health can report your clearance status.
Public health authorities are the exception. When state law requires TB case reporting, your provider can disclose the minimum information necessary to the health department without your authorization. These disclosures are limited to what is needed for public health purposes and do not flow to your employer through this channel.
If You Are Screening for Immigration Instead
The CDC’s healthcare-worker checklist is not part of the immigration medical exam. If you are adjusting status to become a lawful permanent resident, TB screening is handled through Form I-693, the Report of Immigration Medical Examination and Vaccination Record, completed by a designated civil surgeon. As of December 2024, USCIS requires Form I-693 to be submitted at the same time as Form I-485, and failing to include it can result in rejection of the entire adjustment-of-status application.12U.S. Citizenship and Immigration Services. I-693, Report of Immigration Medical Examination and Vaccination Record
The testing requirements also differ. Civil surgeons must use an IGRA blood test for all applicants aged two and older; the skin test alone is not acceptable. If the IGRA is positive, or if the applicant has TB symptoms or a known HIV infection, a chest X-ray is required. Applicants with X-ray findings suggestive of infectious TB, symptoms of active disease, or known HIV must be referred to the local health department for sputum testing.13Centers for Disease Control and Prevention. Tuberculosis Technical Instructions for Civil Surgeons The forms and the rules are separate from the healthcare personnel process described above.