OCAL-4234 - State of Michigan - michigan-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in the emergency telephone numbers. Enter the name and address for each service: Emergency Medical, Doctor, Ambulance, Hospital, Poison Control Center, Fire, and Police/Sheriff. Ensure all phone numbers are accurate for quick access.
  3. In the 'Other' sections, provide any additional emergency contacts that may be relevant. Include their names and addresses as needed.
  4. Complete the fields labeled 'This Telephone No. Is:' and 'This Address is:' with pertinent information regarding your primary contact number and address.
  5. Review all entries for accuracy before saving or printing the document. This ensures that all information is readily available in case of an emergency.

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If you have been immunized in the State of Michigan, you may be able to download your Immunization Record from the Michigan Care Improvement Registry (MCIR) by using the Michigan Immunization Portal.

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