DELCLINATION -RECORD OF TUBERCULOSIS TESTING DECLINATION

TB Testing Declination Statement

I understand that due to my occupational exposure to aerosol transmissible diseases, I may be at risk of acquiring infection with tuberculosis. I have been given the opportunity to be tested annually for this disease at no charge to me. However, I decline annual testing at this time and understand that the fire department will provide testing for me at no charge in the future if I so choose.

12 + 6 =