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6.09.1 – Tuberculosis Questionnaire for Employees


All Open Door employees working at ICF locations will be screened for tuberculosis upon hire. Additionally, employees will undergo annual assessments thereafter.


  • During the pre-employment physical all Open Door ICF employees’ will answer a TB Symptom Assessment form.  This form applies to all employees.
  • The form will be maintained by an assigned nurse who will be responsible for ensuring it’s completion on an annual basis.
  • This form is required to be completed annually by all employees that have a chest x-ray on file.

Last Revised: 8/25/21

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