Mobile health evaluation and screening provider means any provider who is transported in a vehicle mounted unit, either motorized or trailered, and readily movable without disassembling, and who regularly provides evaluation and screening services in more than one geographic location. Minnesota Department of Health (MDH)
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Licensing and Certification - Mobile Health Evaluation and Screening Provider
"Mobile health evaluation and screening provider" means any provider who is transported in a vehicle mounted unit, either motorized or trailered, and readily movable without disassembling, and who regularly provides evaluation and screening services in more than one geographic location.
"Mobile health evaluation and screening provider" does not include any ambulance medical transportation type services or any mobile health service provider affiliated, owned and operated, or under contract with a licensed health care facility or provider, managed care entity licensed under Minn. Stat. Chapters 62D or 62N or Minnesota licensed physician or dentist, nor does it include fixed location providers who transfer or move during the calendar year. All mobile health evaluation and screening providers must be directly supervised by a physician licensed under Minn. Stat. Chapter 147.
Registration Application to Operate a Mobile Health Evaluation and Screening Provider (PDF): Complete and submit this form to apply for an initial registration or renew an existing registration.
Registration Renewal
Registration Application to Operate a Mobile Health Evaluation and Screening Provider (PDF): Complete and submit this form with payment to renew an existing registration.
The completed application and supporting documents can be mailed to:
Minnesota Department of Health
Health Regulation Division
P.O. Box 64900
St. Paul, MN 55164-0900
None.
Mobile Health Evaluation and Screening registrations are renewed annually. Registrants will receive a renewal notification approximately 60-90 days prior to the expiration date of the registration. If you do not receive a renewal notification within 30 days of the expiration date, contact Health.HRD-FedLCR@state.mn.us.
Licensing and Certification - Mobile Health Evaluation and Screening Provider
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