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Date: ________________________
Dear Dr. :
I evaluated your patient, Mr./Mrs. , for tuberculosis
(TB) because he/she applied to adjust his/her status to a permanent U.S. resident. For more information
regarding the evaluation process, please refer to the Centers for Disease Control and Prevention’s TB
Technical Instructions for Civil Surgeons.
The TB evaluation is now complete, and your patient has a diagnosis of latent TB infection (LTBI).
I recommend he/she receive LTBI treatment. Please refer to the following websites for additional
information regarding the diagnosis and treatment of LTBI:
• Centers for Disease Control and Prevention
• California Department of Public Health
• Alameda County Public Health Department
Sincerely,
Dr.