Primary Source Verification Letter
This is an official letter confirming that our website www.bmp.state.mn.us is a primary source for verification of license credentials consistent with the Joint Commission and National Committee for Quality Assurance (NCQA) standards. This letter is used by credentialing verification organizations to comply with credentialing standards of the Joint Commission and NCQA
License Card or Wall Certificate Replacement Request
Request for replacement of annual license card or wall certificate. All replacement documents will be marked Duplicate.
Athletic Trainers
Athletic Trainer Protocol - This protocol form must be updated and reviewed at the athletic trainers renewal time and kept on file by the athletic trainer. It is recommended that the primary physician also retain a copy. Do not submit to the Board unless requested.
Physicians
Dispensing Drugs for Profit Statement must be filed if dispensing drugs for profit. This law refers only to drugs that are: 1) to be administered orally; 2) ordinarily dispensed by pharmacists; and 3) not vaccines.
Physician Assistants
Physician Assistant Collaborative Practice Instruction and Affidavit Form (For new PA applicants who submit the application after August 1, 2020.)
Dispensing Drugs for Profit - Statement must be filed if dispensing drugs for profit. This law refers only to drugs that are: 1) to be administered orally; 2) ordinarily dispensed by pharmacists; and 3) not vaccines.
