Minnesota application for credentialing form

All forms and applications can be found on the right hand side of any page on the website.

We encourage you to download the word form and fill it out electronically.  Please send the document either in Word or PDF format back to us through our contact page.  Use the E-form on that page, and upload the file…Press send.

You can always print and fill out the form by hand.  Our Fax number is 952-466-2133