Snsa minnesota 2026

1. Click ‘Get Form’ to open the snsa minnesota registration form in the editor.
2. Begin by filling out Section A: Identification. Enter your agency name, street address (note that P.O. Box addresses are not acceptable), city, state, zip code, telephone number, hours of operation, email address, after-hours number, and fax number.
3. Proceed to Section B: Ownership. Select the appropriate ownership code and provide the name of the entity responsible for operating the agency along with federal and state tax IDs.
4. In Section C: Management Agent, if applicable, enter the name and address of your management agent. If there are officers or members of a governing body, attach their names and addresses as indicated in Section D.
5. Complete Section E regarding employee licensing and training by verifying compliance with MN Statute §144A.72 and providing an authorized signature.
6. For renewals only, answer Section F about past services provided within the last 12 months.
7. Fill out Section G with specific information about other licenses held by the owner and details on supplemental nursing services offered.
8. Finally, review Section H for verification/registration fee details and ensure all required documents are attached before submitting your application.

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