Los Angeles County
Department of Public Health Tuberculosis Control Program
123 W Manchester Blvd,
Inglewood, CA 90301
Phone: (213) 745-0800
Fax: (213) 749-0926
Email: tbc@ph.lacounty.gov
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Los Angeles County Civil Surgeon LTBI Reporting & Referral
Referral Form for Applicants needing LTBI Treatment Use this form when referring
patients to community clinics for
LTBI treatment. Return this form to the local health department after treatment is completed.
