• Outbreak Reporting Form

    This form helps places like healthcare facilities, schools, colleges, correctional facilities, camps and other group settings report any unusual illnesses or possible outbreaks. These illnesses by include COVID, influenza, respiratory syncytial virus (RSV), norovirus, or other respiratory or stomach illnesses, even if the exact cause is not yet known. Please complete all required and applicable sections of the form so we can review the circumstances and provide guidance as needed.

  • Michigan Department of Health and Human Services (MDHHS) Reporting Requirements for Outbreaks

    In Michigan, any time a setting like a school, workplace, long-term care home, or health care facility notices several people getting sick with the same illness, they need to let their local health deparment know right away. This helps public health staff respond quickly, offer guidance and prevent more people from getting sick.

    If you prefer to notify Mid-Michigan District Health Department (MMDHD) by phone or have any immediate questions, please contact us at:

    Clinton County 989-227-3111
    Gratiot County 989-875-1019
    Montcalm County 989-831-3615
    After Hours Pager 989-276-0260

  • Type of Report*
  • Facility Type*
  • Format: (000) 000-0000.
  • Priority Level*
  • Onset Date of First Case (or of Last Case if final Report)
     - -
    2 digit month, 2 digit day, 4 digit year
  • Epidemiology:
    Rows
  • Symptom Presentation: Residents/Employees/Visitors
    Rows
  • Specimen Testing
  • Specimen Info:
    Rows
  • Source/Control Measures Implemented
  • Date Control Measures Implemented
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: