Get Mn Stemi Receiving Center Designation Application 2020-2025

The Minnesota STEMI Receiving Center Designation Application is a crucial document for hospitals seeking designation as STEMI Receiving Centers. This guide provides clear, step-by-step instructions to help users complete the form efficiently and accurately.

Follow the steps to complete your application

1. Press the 'Get Form' button to download the MN STEMI Receiving Center Designation Application. Ensure you open this form in a suitable editor to fill it out.
2. Identify and include the primary and secondary contacts for your application. The primary contact is responsible for the completion of the application and handling any follow-up queries from the Minnesota Department of Health. The secondary contact acts as a backup.
3. Fill out the application form by indicating the nationally-recognized certification for STEMI care that your hospital currently holds. If the certification is not listed, verify with the Minnesota Department of Health's Cardiovascular Health Unit.
4. Attach documentation of your hospital's STEMI care certification. This should include the name of the certification body, the name of the certification received, the date of certification, and the expiration date. Ensure it is in PDF format.
5. Prepare and include a CEO attestation letter. This letter must confirm the accuracy of the application and be signed by the hospital's CEO or administrator on official letterhead. This letter should also be submitted in PDF format.
6. Compile the application, certification documentation, and CEO attestation letter as PDF documents. Submit these via email to the specified contact at the Minnesota Department of Health.
7. Monitor for any follow-up questions from the Minnesota Department of Health, which will typically occur within one week of submission. Applications are reviewed regularly, and designation certificates will be issued monthly.
8. Once the application is approved, the designation certificate will be mailed to the primary contact listed in your application. The recognized centers will also be listed on the Minnesota Department of Health website.

Take the next step in your application process and submit your Minnesota STEMI Receiving Center Designation Application online.