Get Add/edit Account Form - Minnesota Department Of Health

Filling out the Add/Edit Account Form for the Minnesota Department Of Health can seem daunting, but this guide will walk you through each step of the process. By providing clear instructions, we aim to support users in properly completing and submitting the form online.

Follow the steps to fill out the Add/Edit Account Form.

1. Press the ‘Get Form’ button to obtain the document and open it in your preferred online editor.
2. Begin by entering the 'Date Requested' in the designated field to track when the form is filled out.
3. Provide your 'Agency Name' in the corresponding section, ensuring that it reflects the official name of the organization you represent.
4. Fill in the 'Requestor’s Full Legal Name' accurately. This should be the name you use in official documents.
5. Enter your 'Requestor’s Job Title' to indicate your position within your agency.
6. Sign the form in the 'Requestor’s Signature' field to validate your request.
7. Provide your 'Requestor’s Phone' number for contact purposes.
8. Include your 'Requestor’s E-Mail' address to facilitate further communication.
9. Answer the first security question: 'What is the name of your high school?'
10. Provide your answer to the second security question: 'What is your mother’s legal first name?'
11. Fill in your 'Supervisor’s Name' to indicate the individual responsible for approving your request.
12. Your supervisor must sign in the 'Supervisor’s Signature' field.
13. Include your supervisor’s phone number for any necessary follow-ups.
14. Continue to the next section to choose the permissions required for the user, indicating any additions or changes to existing permissions.
15. Once all sections are completed, save the document. You will be able to download, print, or share the form as necessary.

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