MDCH - Communicable Disease Case Definitions and Case History Forms

Michigan.gov Home	MDCH Home \| Online Services \| Sitemap \| Contact MDCH


>	HIPAA

>	Health Professional Shortage Area

>	Institutional Review Board

>	State Loan Repayment Program

>	Lab Services

>	Public Health Preparedness

>	Communicable & Chronic Diseases

	Michigan Disease Surveillance System


>	Departmental Forms

>	Community Mental Health Services

>	Certificate of Need

>	Toxic Substances

>	Substance Abuse Providers

Printer Friendly Text Only Version

Communicable Disease Case Definitions and Case History Forms

CDC Case Definitions

MDCH Case Definitions

Histoplasmosis Case Definition

Guidelines for Vaccine-Preventable Disease Investigations

Case History Forms

All Case History Forms (except for HIV/AIDS and TB) are available on the Michigan Disease Surveillance System.

FORM #	DISEASE
DCH-1355	Adult HIV/AIDS (Instructions)
CDC 50.42B	Pediatric HIV/AIDS (Instructions)
DCH-0583	Microbiology/Virology Test Requisition/ MDCH
DCH-0453 (formerly IP-10)	School Building Weekly Report of Communicable Disease to Local Health Department
CDC 72.9A	Tuberculosis Case Report
CDC 72.9C	Tuberculosis Supplemental Form

Please contact your local health departmentor the MDCH Communicable Disease Division at (517) 335-8165 for more information.


	Related Content
•	Electronic Laboratory Data Submission to MDCH and the MDSS
•	MDCH Tuberculosis Program
•	Great Lakes Border Health Initiative
•	MDSS Support Resources
•	Michigan Emergency Department Syndromic Surveillance System
•	MDSS Guides and References
•	MDSS Login
•	MDSS Information for Health Care Providers
•	Michigan Disease Surveillance System Background
•	MDSS Frequently Asked Questions
•	MDSS News and Notes
•	Severe Acute Respiratory Syndrome
•	Epi Insight
•	Michigan Department of Community Health SARS Forms
•	Overview of the Division of Communicable Disease
•	Contact Information for the Division of Communicable Disease
•	Communicable Disease Reporting in Michigan
•	Fact Sheets