MI DCH-0713 2016 free printable template
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STATE OF MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES LANSING RICK SNYDER GOVERNOR NICK LYON DIRECTOR Medical Contraindication Form Michigan immunization law requires that a child enrolled in
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How to fill out MI DCH-0713
How to fill out MI DCH-0713
01
Obtain the MI DCH-0713 form from the Michigan Department of Health and Human Services website or local office.
02
Carefully read the instructions provided with the form to understand the requirements.
03
Fill in your personal information in the designated sections, including your name, address, and contact details.
04
Provide information about the child or individual for whom the form is being submitted.
05
Report any relevant health history or special needs as required by the form.
06
Review the form for any errors or missing information.
07
Sign and date the form, ensuring that all declarations are accurate.
08
Submit the completed form to the appropriate office or agency as specified in the instructions.
Who needs MI DCH-0713?
01
Parents or guardians of children enrolled in the Michigan Medicaid program.
02
Caregivers seeking assistance for children with special health care needs.
03
Individuals applying for services through the Michigan Department of Health and Human Services.
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People Also Ask about
Is it illegal to not vaccinate your child in Michigan?
Here's what to know about Michigan's vaccine law So what does Michigan law say about vaccines? The Michigan Public Health Code requires parents to immunize their children against illnesses like polio, diphtheria, tetanus, and pertussis (whooping cough). The law is enforced whenever and wherever children gather.
What to do if parents refuse vaccine?
For parents who refuse one or more recommended immunizations, document your conversation and the provision of the VIS(s), have a parent sign the Refusal to Vaccinate form, and keep the form in the patient's medical record.
Do I have to vaccinate my child for school Michigan?
Knowing school vaccination rules helps ensure your child is ready for school. Michigan students are required to have these vaccines: Diphtheria, tetanus, acellular pertussis (DTaP) Polio.
Do Michigan public schools require vaccinations?
Knowing school vaccination rules helps ensure your child is ready for school. Michigan students are required to have these vaccines: Diphtheria, tetanus, acellular pertussis (DTaP) Polio.
Can I refuse to vaccinate my child in Michigan?
Michigan allows philosophical and religious waivers, which means that no one seeking an immunization waiver for their child is denied. If a child can't receiving a vaccine because of a medical condition, they will need a medical exemption form from their doctor's office.
What is the Michigan law for vaccine exemption?
Michigan allows philosophical and religious waivers, which means that no one seeking an immunization waiver for their child is denied. If a child can't receiving a vaccine because of a medical condition, they will need a medical exemption form from their doctor's office.
How do i get a vaccine waiver in Michigan?
Immunization Waivers To obtain a medical waiver, please make an appointment with your health care provider and have them complete a Medical Contradiction Form. To obtain a non-medical waiver, you will need to make an in-person appointment with a Mid-Michigan District Health Department nurse.
What happens to unvaccinated kids?
Children who are not vaccinated can transmit vaccine- preventable diseases at schools and in the community. Unvaccinated children can infect babies who are too young to be fully immunized. Unvaccinated children can infect people of any age who can't be immunized for medical reasons.
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What is MI DCH-0713?
MI DCH-0713 is a form used in Michigan for reporting certain health-related information, typically related to public health data collection.
Who is required to file MI DCH-0713?
Health care providers, public health officials, and other entities collecting relevant health information are required to file MI DCH-0713.
How to fill out MI DCH-0713?
To fill out MI DCH-0713, one must accurately provide the required information such as patient details, health outcomes, and any other relevant data as specified in the form instructions.
What is the purpose of MI DCH-0713?
The purpose of MI DCH-0713 is to facilitate the collection and reporting of health data for public health monitoring, research, and policy-making.
What information must be reported on MI DCH-0713?
The information that must be reported includes patient demographics, health conditions, treatment provided, and any outcomes related to the health data being reported.
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