This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Disease Control and Prevention and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of this form?
A: This form is a medication tracker for a 3-month course of daily Isoniazid Plus Rifampin for latent Tuberculosis (TB) infection.
Q: What is latent Tuberculosis (TB) infection?
A: Latent Tuberculosis (TB) infection is when a person has been infected with the bacteria that causes TB but does not have active symptoms.
Q: What are Isoniazid and Rifampin?
A: Isoniazid and Rifampin are medications used to treat TB infection.
Q: How long is the course of medication?
A: The course of medication is 3 months.
Q: How often should I take the medication?
A: You should take the medication daily.
Q: What is the purpose of tracking the medication?
A: Tracking the medication helps ensure that you are taking it as prescribed and can help monitor your progress.
Q: What should I do if I miss a dose?
A: If you miss a dose, take it as soon as you remember. If it's close to the time for your next dose, skip the missed dose and continue with your regular schedule.
Q: Are there any side effects of the medication?
A: Isoniazid and Rifampin can have side effects. It's important to discuss any concerns or side effects with your healthcare provider.
Q: Can I drink alcohol while taking this medication?
A: It's best to avoid alcohol while taking Isoniazid and Rifampin as it can increase the risk of side effects.
Q: Can I stop taking the medication once I start feeling better?
A: No, it's important to complete the full course of medication as prescribed, even if you start feeling better.
Q: What should I do if I experience any unusual symptoms while taking the medication?
A: If you experience any unusual symptoms, it's important to contact your healthcare provider immediately.
Form Details:
Download a fillable version of Form CS330204-A by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Disease Control and Prevention.