Find detailed directions on where to return forms and contact information for assistance at the bottom of this page.

Establish a new MCIR site, renew a site agreement, change Site Administrators, update the supervising medical provider, modify information such as address, phone number, or site name, or discontinue a MCIR site.

Site Administrators – How to Add a New or Existing User to a MCIR Site

MCIR Site Agreements must be renewed every 3 years. Site Administrators should renew electronically in MCIR. Use the Provider Site Usage Agreement form if other site changes are needed, such as changing administrators.

Request modifications to a person’s MCIR record information including spelling or DOB corrections, legal name changes, adoptions, or to merge duplicate records.

B&W Version for printed, scanned, or faxed copies.

P4M Adoption Tip Sheet

Request MCIR access as Universal Hospital Hep B, All-Hazard, non-administering pharmacies.

Physicians should complete this form to report a child with a valid medical contraindication to a particular vaccine. Completed forms should be returned to the child’s school or childcare.

Request read-only access to MCIR – for Health Care Organizations or Health Plans only.

Request QUERY-only access to MCIR.

Return Completed Forms (please allow up to 3 business days for processing):
Email: MDHHS-MCIRHelp@michigan.gov
Fax: 517-763-0370
Please provide contact information on the form so the Help Desk can contact you with any questions. Forms will be returned for missing or incorrect information.

For technical assistance with MCIR or form questions, contact the MCIR Help Desk:
Phone: 888-243-6652
Email
: MDHHS-MCIRHelp@michigan.gov
MILogin: 877-932-6424, option 5 for password reset

MCIR Help Desk Hours of Operation:
Phone: Monday – Thursday 10AM – 12PM and 1PM – 4PM
Email: Monday – Friday 8AM – 4:30PM