Date of Birth(Required)
TB Testing Acknowledgement(Required)
New Hires: Screening Process TB Document G from the State of Hawaii Department of Health may be obtained from your health care provider. In most cases, a test is not necessary and this form can be uploaded here to meet your TB requirement. If you are required to test for TB, then please submit proof of Negative Test taken within the 12 months prior to your hire date to meet the requirement. Contact your provider for more information.
Max. file size: 2 MB.
Please compress the image to a small size if possible. 🙂
Confidentiality of Personal Identifiable Information(Required)
Code of Conduct(Required)
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