Forms for Applicants
Overview of the Licensure Process
The Minnesota Board of Medical Practice issues licenses/registrations to physicians (medical license, residency permit, telemedicine), physician assistants, acupuncturists, athletic trainers, naturopathic doctors, respiratory therapists, traditional midwives, and professional firms. There are currently 28,000 physicians, allied health professionals and professional firms regulated by the Board. In 2023, 3,000 licenses were issued with every licensee reviewed and evaluated prior to being licensed. Each profession has its own practice act setting forth license/registration initial and continuing education or practice requirements, scope of practice, grounds for disciplinary action, and Council composition/duties.
Note: All forms on this page are PDF files and will open in a new window or tab.
Physician
- Physician Application Packet (option 1 - Full Medical License Application)
- Certification of Medical Education
- Dispensing Drugs for Profit
- Facilities List
- Malpractice History Report
- Malpractice liability claims information form
- Physician Emeritus Application
- Physician Verification of Licensure
- Residency Permit Application (For Paper Application)
- Approved Residency Training Program Form ( For Online Application Upload)
- Approved Residency Training Program Extension Form ( For Online Application Upload)
- Approved Residency Extension Form ( For Paper Application)
- Telemedicine Registration Application
- Telemedicine Application Affidavit Form
- Verification of Postgraduate Medical Training
- Medical Faculty License Application Packet
- Physician Affidavit and release form
- Online Application Physician Facility List Form
Physician Assistant
- Physician Assistant Application Packet
- Physician Assistant Collaborative Practice Attestation Form (For new PA applicants who submit the application after August 1, 2020).
- New applicants and exiting licensees don't need to submit Delegation Agreement and Practice Location Notification to the Board after August 1, 2020.
- Dispensing Drugs for Profit
- PA Direct verification of education
- Direct verification of all PA and other healthcare credentials
- PA Online Application Affidavit From
All Others
- Acupuncturist Application Packet
- Acupuncturist Application Verification of Licensure Form
- Athletic Trainer Application Packet
- Athletic Trainer Application Verification of Licensure
- Genetic Counselor Application Packet
- Genetic Counselor Verification of Licensure and Registration
- Genetic Counselor Verification of Education
- Naturopathic Doctor Application Packet
- Naturopathic Doctor Application Verification of Education
- Naturopathic Doctor Application Verification of Licensure
- Professional Firm Application Forms
- Respiratory Therapist Application Packet
- Respiratory Therapist Verification of Employment
- Respiratory Therapist Verification of Licensure and Registration
- Respiratory Therapist Verification of Education
- Athletic Training Work History Form
- Traditional Midwife Application Packet
- Traditional Midwife Application Verification of Licensure
- Traditional Midwife Application Consultation Plan
- Online Application Affidavit of Applicant