Health and Mantoux TB Test Form

Teacher candidates may bring this form to their medical professional when updating their Mantoux TB Test results. Generally, pre-clinical interns and clinical interns (student teachers) working as volunteers in the classroom for more than 20 hours a month must show evidence that they are free of active disease while attending their clinical placement. Schools and school districts routinely request that you show evidence that you are free of active infection with TB. If you have not updated your test status within the past six months, you may be required to be retested before beginning your placement.

This is the form that needs to be completed: