Guidelines for Referrals to the San Francisco TB Clinic
To refer patients to the San Francisco TB Clinic, please complete the interagency TB47 referral form. We are not able to see patients without a referral.
We do not accept referrals for:
- General TB screening
- Employment or school TB screening
- Asymptomatic patients with prior history of completing LTBI treatment
- Asymptomatic patients with positive TST or IGRA (QFT or T-spot), normal chest x-ray, and no special medical condition
Referred patients must be residents of the City and County of San Francisco and have one or more of the following criteria for referral:
- Patients with suspected or confirmed active TB disease, including:
- Patients with symptoms consistent with active TB disease
- Patients with abnormal chest x-ray consistent with active TB disease
- Patients must be reported directly to the San Francisco TB Clinic. Do not send patients directly to the clinic as drop-in. More reporting details at Suspected/Confirmed Active Case Reporting.
- A TST reading ≥ 5 millimeters or positive IGRA (QFT or T-spot) with abnormal or normal chest x-ray and any of the following risk factors or special medical conditions which increase risk of progression to active TB disease:
- Children under 5 years of age (0-4 years old)
- Contact to active TB cases
- New TB test conversion to positive (previously documented negative TB test)
- Asymptomatic persons with radiographic evidence of old, healed TB
- HIV
- On immunosuppressive drugs (steroids, cancer chemotherapy, post-transplantation cyclosporine, TNF-alpha antagonist or other biologic agent)
- Complicated LTBI treatment:
- Intolerant of > 1 LTBI regimen and has a risk factor for progression
- Viral hepatitis and drug-induced hepatitis: LFTs > 3x WNL with symptoms or > 5x WNL without symptoms
- On medication-assisted treatment for substance use disorder and has a risk factor for progression
- LTBI with immunosuppression and requires DOT
- Patients without a medical home requiring program or shelter clearance