Tuberculosis (TB) - Wallet Card for Recording TB Skin Test Results

To order wallet cards, fill out form F-80025a.

Reference the Form/Publication below that is in the language you want and email your request directly to the DPH contact. The quantity you request will be sent to the SHIP TO: address you specify.

  • F-44756 - Wisconsin tuberculosis record (English)

  • F-44756S - Wisconsin tuberculosis record (Spanish)

  • F-44756H - Wisconsin tuberculosis record (Hmong)

 

Contacts

Wisconsin Local Health Departments - Regional offices - Tribal agencies

Respiratory Diseases and International Health Unit

Division of Public Health
Bureau of Communicable Diseases
1 West Wilson Street
Madison  WI 53701-2659
608-266-0049 - Secure Fax


      Jo Mercurio - Office operations
         608-266-9692
      Pa Vang - TB nurse consultant 
         608-266-9452 
      Philip Wegner - TB nurse consultant
         608-266-3729
      Savitri Tsering - Refugee health coordinator 
         608-267-3733

Last Revised: July 9, 2015