Macomb County (Not MCIR) Contact Information Update Form 

Administrators and reporters, to update your contact information, please complete this form and submit to the Macomb County School Immunization Program. Accurate contact information will allow you to receive important information regarding MCIR reporting from the Macomb County Health Department. 

To change your contact information in MCIR, follow this link for instructions:  HOW TO REGISTER FOR A MILOGIN FOR BUSINESS ACCOUNT (formerly MILogin for Third Party)

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Site *
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Site Name *
Site District: If Applicable
Site Address *
Site Phone # *
Schools only: Superintendent First & Last Name
Schools only: Superintendent Email
Principal, Director or Administrator (choose one) First & Last Name *
Principal, Director or Administrator: Phone # *
Principal, Director or Administrator: Email *
Reporter one: First & Last Name *
Reporter one: Phone # *
Reporter one: Email *
Reporter Two: First & Last Name
Reporter Two: phone #
Reporter Two: Email

Please list names/emails of any contacts that need to be deleted from the Macomb County School Immunization records: 

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