TB/LEAD Screener

Please correct the errors described below.

TB Screen Risk Assessment

State of Hawaii TB Risk Assessment for Adults and Children

TB Risk Factors

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

LEAD RISK SCREENING QUESTIONS FOR AGES 6 MONTHS TO 6 YEARS

Home or Child Care Center

Lead was added to indoor and outdoor paint until1978. When lead-based paint surfaces rub together (like when a window is opened or a door closed), when paint begins to peel or chip, or renovations are done on the house, the lead can get into the dust and dirt in and around the house.

Jobs or Hobbies

Add new row

Food and Water

A rainwater cachement system is when you collect and storing rainwater for watering plants, cleaning, bathing, or drinking.

Air contamination causes rainwater to become acidic adds heavy metals such as lead into rainwater. The way the rainwater is collected and stored (eg. zinc roofing ) can also add heavy metals ,like lead, into water.

CDC Rainwater Collection Information

https://www.cdc.gov/healthywater/drinking/private/rainwater-collection.html

Guidelines on Rainwater Catchment Systems in Hawaii

https://www.ctahr.hawaii.edu/oc/freepubs/pdf/RM-12.pdf

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Your information will be encrypted.

Loading...