Patient case management
Wisconsin Case Management for Active TB Disease Treatment P-00647 (PDF, 213 KB)
Anti-tuberculosis therapy
- Tuberculosis INFECTION Initial Request for Medication (F-00905) (PDF, 487 KB)
- Tuberculosis DISEASE Initial Request for Medication (F-44000) (PDF, 3.8 MB)
- Medication Refill Request (F-44126 "pink sheet") (PDF, 40 KB)
- Follow up on Therapy (F-44125 "green sheet") (PDF, 47 KB)
- TB Suspect Case Fata Form (F-42001) (PDF, 226 KB)
- Interjurisdictional Tuberculosis Notification (F-42010) (PDF, 24 KB)
- Interjurisdictional TB Notification Follow-up (F-42011) (PDF, 87 KB)
- Dispensary Pre-authorization for Non-routine TB Services (F-01459) (PDF, 42 KB)
For more information or questions, contact the Respiratory Diseases and International Health Unit or your Wisconsin local health department.
Last Revised: June 8, 2016
