Michigan SEC
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Case Information
Case Type
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Child/Family Focused Case
Programmatic Case
Targeted Case (Deprecated DO NOT USE)
Child Initials
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Program Name
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Referral Source
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Provider
Resource Center Staff
Social Emotional Consultant
Substance Abuse Prevention Specialist
Other
Other Referral Source
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County/Program ID
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Consultant ID
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Child Care Provider ID
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Child ID
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Insurance Information
Does the child have Medicaid/MiChild coverage?
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Yes
No
Unknown
Demographic Information
Age (in months) at Pre-assessment
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Gender
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Female
Male
Race
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African American
American Indian/ Alaska Native
Asian
Native Hawaiian/ Pacific Islander
White
Of more than one race
Other
Unknown
Refused Identification
Ethnicity
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Hispanic or Latino
Not Hispanic or Latino
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Form Status
Case Status
Opened
Closed Complete
Closed Incomplete
Additional Information
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Case Status
Open
Closed - Complete
Closed - Incomplete
Case Notes
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