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Confidential Communicable Disease Report Form - DHHS 2124
(PDF) - Physicians and healthcare providers may use this form to notify the local
health department of reportable communicable disease cases.
Nursing Record of TB Contacts (DHHS
1662) (PDF, 199KB / Revised May 2025)
Record of TB Screening (DHHS
3405) (PDF, 227KB / Revised May 2025)
SLPH Mycobacteriology Lab Requisition (DHHS
1247) - Specimens for isolation and identification of all Mycobacterium
species (including Mycobacterium tuberculosis complex and other nontuberculous
mycobacteria) are accepted from public and private health care providers.
Order Form for TB Control Materials (DHHS
2407) (PDF, 172KB / Revised June 2017)
TB Biologicals Requisition and Inventory (DHHS
3093) (PDF, 643KB / Revised May 2025)
Report of Positive Smear (AFB) and/or Positive Culture of TB (DHHS
3005) (PDF, 362KB / Revised May 2025)
Individual Contact Form (DHHS
4097) (PDF, 147KB / Revised May 2025)
Tuberculosis report worksheet for Healthcare
Providers (PDF, 102KB) - The N.C. Tuberculosis Control Program has developed this
worksheet to help hospital infection control nurses and other healthcare providers organize
and quickly reference the information they will need to provide the local health department
when reporting a suspected or confirmed tuberculosis case.