TB Surveillance Note***

***Have you recently updated your PPD/TB test outside of UCSF Occupational Health Services (OHS)?

(e.g. at ZSFGH, CPMC, Kaiser, or your own primary care provider)?

Otherwise, notify us of any other updated information by using the form below.

All Other Expirables (CA license, DEA, etc.)

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First Name *

Last Name *

Title *

Provider ID

Expiring Certificate/License *

Please select which expiring information you're updating:

Expiration Date *

Please let us know the new expiration date for your license/certificate.

Year

Month

Day

Leave this field blank

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