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Get MI DCH-0453 2006-2024

H department shall be notified immediately of the occurrence of communicable disease (especially rash-like illnesses with fever). In addition to immediate notification by telephone, please include all occurrences on this form and mail to your local health department. 1 SCHOOL OR PRESCHOOL: WEEK ENDING: ↑ INSTRUCTIONS 2 A: B: C: D. CURRENT SCHOOL ENROLLMENT: DISTRICT: Record appropriate information in Sections 1, 2, 3, 4 & 5. Simply fold, scotch tape, stamp and mail. MAIL EACH FRIDAY .

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