Clinical Forms | Branch Hillsdale St. Joseph Community Health Agency

Coldwater 517-279-9561

Hillsdale 517-437-7395

Three Rivers 269-273-2161

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Clinical Forms

Influenza Clinic Form: posted 11/17/2020 (updated)
Physicians Office Weekly CD Reporting Form
Varicella Case Report Form
CD Reporting School and Daycare - Branch County
2020 February Hillsdale
CD Reporting School and Daycare - Hillsdale County
CD Reporting School and Daycare - St. Joseph County
v-safe
Mass Clinic Instruction Sheet
COVID-19 Vaccination Form
How to Schedule a COVID-19 Vaccination
How to Schedule a COVID-19 Vaccination en Espanol
COVID-19 Vaccination Form Spanish
Covid-19 Parental Consent Form
Pfizer 5-11 Fact Sheet

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About BHSJ

Board of Health

Board of Health Meeting Schedule

Board of Health Meeting Agenda/Minutes

Organization Information

- Strategic Plan

- Mission and Vision

- Agency Organization Chart

Administrative Contact Information

Health Officer

Rebecca Burns MPH, RS
517-279-9561 ext. 148

Medical Director

Karen Luparello, DO
(517) 279-9561

Administrative Services Director

Theresa Fisher BS, A+
517-279-9561 ext. 107

Environmental Health Director

Paul Andriacchi REHS
269-273-2161 ext. 229

Personal Health and Disease Prevention Director

Kali Nichols MPH
(517) 279-9561 ext. 143