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REGISTRATION TO PROVIDE TELEHEALTH DURING COVID-19 EMERGENCY UNDER MINNESOTA EMERGENCY EXECUTIVE ORDER 20-28

  • Out-of-state licensed mental healthcare providers allowed to register with Boards of Social Work, Psychology, Marriage and Family Therapy, and Behavioral Health and Therapy, to provide telehealth to meet needs of emergency
  • Executive Order 20-28 authorizes out-of-state mental health providers to treat Minnesota patients via telehealth services to help ensure that the mental health needs of Minnesotans are met during the stress and uncertainty the COVID-19 pandemic
  • Before rendering any such aid in this state, such healthcare providers shall (a) complete the registration form required by the appropriate Minnesota health-related licensing or regulatory board, and (b) receive from the appropriate Minnesota health-related licensing board an acknowledgment of receipt of the registration form
 

Complaint Registration

Complaint Registration Form


CE Providers

CE Providers Application


Applicants

Application Action Steps

Apply for a License Online

Application for Licensure (paper)

360 Clock Hours Forms 1-3 (Submit ONLY with Application for LICSW)

Verification of Licensure Form

ADA Examination Accommodations Application Form

ESL Examination Accommodations Application Form

Apply for Temporary License (online)

Temporary License Application (paper)


Licensees

Apply to Renew Online

Application for Renewal (paper)

Apply to Reactivate an Expired License Online

Application for Expiration from Expiration or Voluntary Termination (paper)

Name Change Form


Supervision

CLINICAL Supervision Plan Form

CLINICAL Supervision Verification Form

NONCLINICAL Supervision Plan Form

NONCLINICAL Supervision Verification Form


Provisional License Forms

Provisional License Application

Provisional License Supervision Plan Form

Provisional License Six Month Evaluation Form

Provisional License Final Evaluation Form


Data Requests

Data Request Form - Data Subject

Data Request Form - Public

Data Request Form - Public Data Mailing List


Professional Firms

Professional Firm Annual Report Form

Professional Firm First Report

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