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Telemedicine Registration Application

Effective July 1, 2002, the telemedicine law takes effect requiring physicians who are practicing telemedicine and are not licensed to practice medicine in Minnesota to register with the Minnesota Board of Medical Practice. There is a $100 application fee and a $75.00 annual fee including 10% e-Licensing surcharge. Registration is renewed annually based on a calendar year. To be eligible for telemedicine registration, a physician must be licensed in the state from which telemedicine services are provided and must not have ever had a license to practice medicine revoked or restricted in any state or jurisdiction.

Telemedicine Application Form (PDF)

Print application, complete, mail with $175.00 fee to:

Minnesota Board of Medical Practice
University Park Plaza
2829 University Ave SE, Suite 500
Minneapolis, MN 55414-3246

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