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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
To report this change, gather the information needed and call the MNsure Contact Center at 651-539-2099 (855-366-7873 outside the Twin Cities).
Who do I report a change to? If someone in your household gets MA, report a change to your county or tribal agency. If no one in your household gets MA, but someone in your household does get MinnesotaCare, report a change to DHS Health Care Consumer Support at 800-657-3672 or 651-297-3862.
How to File a Complaint Contact a Regional Ombudsman for the county the person is in. Use the Regional Map or the Regional Ombudsman by County list. Call the OMHDD: 651-757-1800 or 1-800-657-3506. Email the OMHDD:ombudsman.mhdd@state.mn. Fax the OMHDD: 651-797-1950. Send us a letter by US postal mail:
Apply for benefits We're changing the way we serve you by offering services in a way that is more convenient for you. Apply for economic benefits whenever, wherever. Apply online or call 612-596-1300 Monday through Friday, 9 a.m. to 4 p.m.
Hennepin County Public Health works to improve the health of all county residents by addressing social and environmental factors that impact their health and offering programs and services that help them be healthy. Our department is committed to advancing health and racial equity.
Get help. Call the Hennepin County Managed Health Care Office at 612-596-8860 for help with enrollment questions, billing questions, or complaints.
Call 612-348-3000, Monday through Friday, 8 a.m. to p.m.
If you do not have your probation officer's contact information, email poconnect@hennepin.
In 2018, HCMC became Hennepin Healthcare.