Doula Registry Application & Renewal - Minnesota Department of Health

Applying and Renewing:
Minnesota Doula Registry

Applying for your registration

Fill out and complete all parts of the application below:

A check or money order for $200 should be made payable to:
Minnesota Department of Health

Mail the Doula Registry Application, a copy of the Verification of Credential, and the fee listed to:

Minnesota Department of Health
Health Occupations Program
Attn: Doula Registry
PO Box 64882
St. Paul, MN 55164-0882

Mail the Doula Verification of Credential (PARTS I and II) provided in the application to your certifying organization.

MDH Notification

Once MDH receives your application, a verification and criminal background check will be conducted. You will receive a letter notifying you that your name has been added to the Minnesota Doula Registry.

Renewing your registration

Inclusion on the registry maintained by the Commissioner is valid for three years. Approximately sixty (60) days prior to the expiration of your three-year registration period, you will be mailed a new application. If you wish to remain on the registry, fill out all parts of the application and follow the instructions above for submitting your application and fee.

If you receive a certificate from your certifying organization, please include a copy of it with your application and fee. MDH will then conduct another verification and criminal background check. You will receive a letter from MDH notifying you that your registry has been extended for another three-year period.

Application or Renewal Instructions

Instructions

Complete all parts of this application and PART I of the attached Doula Verification of Credential form. If you need additional space, list on a separate piece of paper, sign, date, and enclose. Make check or money order made payable to the “Treasurer, State of Minnesota” in the amount of $200.00. Mail the completed application with a check or money order to the address shown below. Mail PARTS I and II of the Doula Verification of Credential to your certifying organization.

Verification

The Commissioner of the Minnesota Department of Health will use the information provided in this application to verify that you meet the statutory definition of a certified doula. A certified doula means an individual who has received a certification to perform doula services from the International Childbirth Education Association, the Doulas of North American (DONA), the Association of Labor Assistants and Childbirth Educators (ALACE), Birthworks, the Childbirth and Postpartum Professional Association (CAPPA), Childbirth International, the International Center for Traditional Childbearing, or Commonsense Childbirth, Inc. (Minnesota Statutes, Section 148.995, Subd. (2)).

Criminal Background Check

The Commissioner will conduct a criminal background check by reviewing the website of the Minnesota Bureau of Criminal Apprehension. If the review indicates that an applicant has a criminal conviction, then pursuant to Minnesota Statutes, Section 148.996, Subd. (3), the Commissioner will indicate this on the registry and provide a link to the web site of the Minnesota Bureau of Criminal Apprehension.

Renewal

Inclusion on the registry maintained by the Commissioner is valid for three years. Approximately sixty (60) days prior to the expiration of the three-year period, you will be mailed a new application. If you wish to remain on the registry, complete and mail the application with a check or money order made payable to the “Treasurer, State of Minnesota” in the amount of $ 200.00 to the address shown below. If you receive a certificate from your certifying organization, include a copy with your application and fee. The Department will then conduct another verification and criminal background check as outlined above.

Minnesota Government Data Practices Act Notice

This notice is given pursuant to Minnesota Statutes, 13.01, Subdivision 3. The data you provide on this application is considered public data under the Minnesota Government Data Practices Act. You are not legally obligated to complete this application; however, if you do not complete the application, you cannot be listed on the Doula Registry. The information you provide will be subject to verification and a criminal background check.

Updated Monday, 05-Aug-2019 16:11:23 CDT