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Registration for Voluntary Health Care Provider Program

The Administrative Services Unit of the Health Licensing Boards has established a volunteer health care provider program to facilitate provision of health care services provided by volunteer health care providers through eligible health care facilities and organizations as defined in Minnesota Statutes Section 214.40.

To participate, a health care facility or organization must register with ASU by completing:

  1. the Registration Form (Form A),

  2. Volunteer Participant Roster (Form B), and

  3. Affidavit of Organizations Registration (Form C).

To participate as an individual health care provider seeking individual medical malpractice insurance coverage, the applicant must apply to the Administrative Services Unit.

To access either Registration form via the Internet and to obtain a copy of the Volunteer Health Care Provider Program, access the Administrative Services Unit Web page at

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