MODULE B
6.5 Return an updated Acknowledgement Form to the referring DOTS facility As soon as a definitive diagnosis has been made at the Treatment Center, you need to inform the referring DOTS facility of the diagnosis and plan for the patient. This is done using the same Acknowledgement Form that is used during screening. This is accomplished in duplicate copies, one for the referring facility through the patient and the other attached to the patient’s records in the Treatment Center. Tick the box for “Final diagnosis”. On this form the physician writes the name of the referred patient, the pertinent laboratory findings particularly DST, the final diagnosis, and the recommendations. If however, the patient has not called or returned to the Treatment Center to pick up his results, the Acknowledgement Form will be sent by facsimile to the referring facility with request for assistance to locate the patient. All efforts should be done to contact the patient, e.g., by land or cell phone, or by a visit. An example of the Acknowledgement Form for final diagnosis is shown in the next page.
Detect Cases of MDR-TB
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