Case Information Request Form

Please email MCAC's Case Manager, Emma David, at ehdavid@baymills.org with further information/requests as needed. MCAC's Case Manager will review all requests and decide accordingly. Information shall only be shared as absolutely necessary for an investigation, under the role provided in the request. DO NOT submit this form on behalf of someone else. All incomplete or inconsistent forms will be rejected. Decisions will be made in accordance to pre-existing releases of information, HIPAA protections, PII guidelines, Forensic Interview Protocol, State and Federal laws, etc.

First name

Last name

Position

Agency (include county)

Child's/case name

Who is currently assigned to/involved with the case in your discipline?

What information is being requested?

Reason for request

Do you have an NCATrak Account through MCAC?

Yes

No

Would you like to set up an NCATrak Account through MCAC?

Yes

No

NCATrak is the online case file system used by MCAC. This platform is used by MDT members to add updates about the progress of a case. You will only have access to information specific to your discipline.

Mashkawizii Child Advocacy Center

Case Information Request

Case Information Request Form

Mashkawizii Child Advocacy Center