Get Mi Dch-0713 2020

Filling out the MI DCH-0713 is a vital process for obtaining a medical exemption for immunizations. This guide will assist you in navigating the online form, ensuring you accurately complete all required sections with ease.

Follow the steps to successfully complete the MI DCH-0713 online.

1. Press the ‘Get Form’ button to access the MI DCH-0713 document and open it in your preferred online editor.
2. In the first section, fill in the child's name, including their last name, first name, and middle initial as required. Ensure accuracy in spelling.
3. Provide the date of birth of the child in the format of month/day/year. Double-check for correctness to prevent any issues.
4. Enter the name of the parent or guardian who is filling out the form.
5. Complete the home address section with the full residential address of the child.
6. Include a telephone number where the parent or guardian can be reached.
7. Specify the preschool program, childcare center, or school name where the child is enrolled.
8. Indicate the vaccinations that are medically contraindicated by checking the relevant boxes. Be sure to review the list to ensure all applicable vaccines are selected.
9. Provide a detailed reason for the exemption as required. It is advisable to refer to the provided medical contraindications resource.
10. State the expiration date for the exemption in the format of month/day/year.
11. Print the name of the physician (MD/DO) providing the medical certification.
12. Fill in the physician's office address for accurate correspondence.
13. Add the physician’s telephone number for any necessary follow-up regarding the exemption.
14. Ensure the physician (MD/DO) signs and dates the form to validate it.
15. Once all sections are completed, save your progress. You can then download, print, or share the form as needed.

Start completing your MI DCH-0713 form online today to ensure compliance with Michigan's immunization requirements.