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Positive PPD Questionnaire
Residents who CANNOT undergo an annual PPD test due to a previous positive, BCG vaccine, etc., must complete the Positive PPD Questionnaire annually. Click here for a copy to print, complete and return to KJL HealthCare Management Inc. by fax or mail (info below).
Temporary Waiver of Annual PPD Requirement
Residents who cannot undergo an annual PPD test at this time (ex: pregnancy), but will at a later date, click here for a copy of the Temporary Waiver form to print, complete and return to KJL HealthCare Management, inc. by fax or mail (info below).
Return the above forms or PPD result documentation to:
KJL
HealthCare Management, Inc.; 10746 East Dorado Avenue; Englewood,
CO 80111.
Fax: 303-290-6794.
Immunization Screening Forms
Immunization Screening & TB Respirator Mask Fits are mandatory for all reidents new to UCD Graduate Medical Education programs and must be completed within one week of the resident's training start date.
To
schedule appointments contact:
Kristin Lee, RN, BSN (KJL HealthCare Management)
klee80111@comcast.net
Phone: 303-913-7399 Fax: 303-290-6794
Before the scheduled appointment, the resident is to complete and forward the Infectious Disease & Immunization Summary & Screening-Related Forms.
These forms are in the new resident packet distributed in March each year. Forms are also available on line by clicking on the above link.
Residents should completely fill out the 5 page form, place it in the 6x9 envelope provided in the packet, print his/her name and program legibly on the outside of this envelope and return it, along with the rest of the packet, to the Program Coordinator. Coordinator will forward to GME with other packet paperwork.
Residents who do not complete these requirements endanger themselves, their families, colleagues and patients; are in violation of their training agreement and are non-compliant with state, federal and affiliated hospital regulations. Please be certain each new resident in your program completes the immunization screening and TB Respirator Mask Fit.