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Forms

• Abortion Reporting Forms Download Abortion Reporting forms, Abortion Complication forms and the handbooks on completing them.

• Affidavit of Parentage Download Affidavit of Parentage forms.

• Birth Defects Reporting Forms Download the birth defects reporting form, birth defects reporting handbook, the cytogenetics reporting form and the cytogenetics reporting manual.

• Communicable Disease Case Definitions and Case History Forms Information on case definitions and case history forms for reportable diseases and conditions.

• Death Certificate (Revised) Instructions for completing the revised death certificate (1/2004). Includes the latest Michigan Place Name List and a sample death certificate.

• Fetal Death Reporting Forms Download the fetal death reporting forms and instructions.

• HIV/Hepatitis Testing Forms

• Michigan Cancer Surveillance Program Download the current Michigan Cancer Surveillance Program Cancer Report Form, Cancer Program Manual, and other MCSP-related documents.

• Michigan's Dignified Death Act PDF icon Information about your right to make choices about your medical treatments. This includes the right to accept or refuse any treatment that is offered to you. It also covers your right to have someone else make choices for you if you can no longer choose for yourself.

• Verification of Pregnancy & Gestational Age For local health department use only. Completion is required if the patient requests a pregnancy verification and determination of gestational age in order to fulfill the requirements of the Informed Consent for Abortion Law, PA 345 of 2000.





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