ONLINE REPORTING INSTRUCTIONS: Please record all appropriate information and submit each MONDAY by 11AM EVEN IF THERE ARE NO DISEASES TO REPORT. Click "Submit Data" at the bottom of the page to send it to the health department.
*Highlighted fields are required*
WEEK ENDING: Friday,
*Hospitalized or severe cases of H1N1 Influenza should be reported below under individual disease reporting!
*The principal symptoms of COVID-19 are fever or chills, sore throat, cough, diarrhea, vomiting, fatigue, congestion, new onset of a severe headache, and new loss of taste or smell
DATE OF BIRTH
Choose Disease
ADDITIONAL COMMENTS:
PLEASE CHECK IF:
NO DISEASES TO REPORT THIS WEEK
SCHOOL CLOSED DUE TO ILLNESSES
SUBMITTED BY:
PHONE NUMBER:
TODAY'S DATE:
For more information, contact Mikayla Benbow at the Genesee County Health Department at 810-257-3869 or [email protected]. Click here to print out and fax this form instead. (Adobe Reader is required to view and print this PDF.)