TB Screening

TB Questionnaire
This assessment has been compiled by a team of highly qualified professionals in the Fitness, HR, Stress and Conflict, Health and Financial well-being space.

All security measures have been taken to keep your information safe. No personal data will be transferred from this assessment.
1. Employee Details
2. Questionnaire

Part 1

How are you feeling today?.
1. Do you have a cough?
2. Are you feverish? (Does your forehead feel warm to the touch?)
3. Do you sweat at night, more often than usual?
4. Have you been losing weight without trying?
5. Are you at high risk of getting TB?
You are at high risk of TB if:
* You live with someone who has/had TB in the last year
* You have had TB in the last 2 years
* You are living with HIV

Part 2

Have you had any of the following symptoms in the past 12 months?
1. A productive cough lasting more than three weeks?
2. Coughing up blood (Hemoptysis)?
3. Unusual weight loss?
4. Unknown cause of fever, chills, or night sweats?
5. Do you have chronic shortness of breath?
6. Unexplained fatigue?
7. Do you have chest pain?
Kindly confirm that the details you provided are accurate to the best of your knowledge and that Company Wellness Solutions has your permission to contact you if necessary.
Your replies to the questions show that :
You need a TB test:

  • Go to your local clinic for a free TB test.
  • Please put on a face mask before you enter the clinic
Your replies to the questions show that :
You don't need a TB test at this time.

If you develop a cough, fever, weight loss or night sweats, visit your nearest clinic.

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Consent for Cancer Screening:

By proceeding with the cancer screening, you hereby give your voluntary and informed consent to undergo the screening process. You understand that the purpose of this screening is to detect early signs of cancer and improve the chances of early diagnosis and treatment.

You have the right to withdraw your consent at any time during the screening process, without any negative consequences or impact on your future medical care.

Data Handling and Privacy:

  • Data Collection: During the screening, we will collect personal information, including but not limited to your name, contact details, medical history, and test results.
  • Data Storage: Your information will be securely stored in our database using industry-standard encryption and access controls. We take all reasonable measures to protect your data from unauthorized access or disclosure.
  • Data Use: The information collected during the screening will be used solely for the purpose of conducting the cancer screening program. This data may be analyzed to improve the effectiveness of our screening methods and may be used in an anonymized form for research and statistical purposes.
  • Data Sharing: In the event that the screening indicates the need for further medical evaluation or treatment, we may share your information with relevant healthcare professionals, including specialists and medical facilities. This is done to ensure appropriate and timely medical attention for your well-being.
  • Anonymity: When your data is used for research or statistical purposes, it will be anonymized and aggregated to protect your identity.

Contact Information:

If you have any questions or concerns about the cancer screening process, data handling, or privacy practices, please feel free to contact us at support@companywellness.co.za