Reporting Instructions for Civil Surgeons

What should be reported?

Civil surgeons are required to report tuberculosis (TB) screening outcomes that result in latent TB infection (LTBI) or active TB disease to the local health department (LHD) in which their patient resides. 

All reporting notifications to local TB programs should include: applicant’s name, contact information, IGRA results, chest x-ray report, and treatment results.

Visit the CTCA Directory to contact your local TB program for specific reporting or referral instructions.

Report or Refer? Category Definition Note
Report Latent TB Infection (LTBI)

Positive IGRA

Chest x-ray not suggestive of TB disease

No known HIV status

No signs or symptoms of active TB disease

Applicants who have written documentation of completing LTBI treatment prior to the civil surgeon examination do not need be to reported.
Refer Applicants with HIV infection If the applicant has known HIV infection, an IGRA and chest x-ray must be performed. Regardless of the results, the applicant must be referred to their LHD of residence for sputa collection.
Report and refer Active TB disease (suspected or confirmed)

Abnormal chest x-ray suggestive of TB disease, regardless of symptoms

Clinical signs or symptoms of suggestive TB disease

Extra pulmonary disease, regardless of chest x-ray results

Any confirmed or suspected case of active TB disease is required, by law, to be reported to the applicant’s LHD of residence within one business day.

How should LTBI be reported?

All civil surgeons in the United States are now required by the Centers for Disease Control and Prevention (CDC) to use an online system called eMedical to report persons adjusting their immigration status who are found to have latent TB infection (LTBI).

We encourage you to stop using the CalREDIE Provider Portal, and to report LTBI using eMedical. Your local health department may contact you with any additional reporting instructions.

Please see the “What should be reported?” box at the left of this page for information on referring patients who need additional evaluation for TB.

Resources for eMedical reporting

How should suspected or active TB be reported and referred?


California civil surgeons should contact their local TB program for specific instructions to refer suspected or active TB disease.

Many LHDs prefer notification via phone, secure fax, or secure email, in addition to submission of a Confidential Morbidity Report (CMR).

Visit the CTCA Directory to contact your local TB program for specific reporting and referral instructions.


U.S. Citizenship and Immigration Services

Form I-693 – Report of Medical Examination and Vaccination Record

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