Minnesota Health Care Loan Forgiveness Forms
The forms listed here are for awardees and current participants only. Please do not complete and/or submit these forms unless instructed to do so by the Program Administrator.
If you have any question, please contact us at: health.loanforgiveness@state.mn.us
Forms for the eligible professions:
- Qualified Loan Form
- Verification Form
- Advanced Practice Provider Confirmation of Practice
- Advanced Practice Provider Verification of Employment
- Allied Health Care Faculty Confirmation of Practice
- Allied Health Care Faculty Verification of Employment
- Dentist Confirmation of Practice
- Dentist Verification of Employment
- Long Term Care Nurses Confirmation of Practice
- Long Term Care Nurses Verification of Employment
- Nurse Faculty Confirmation of Practice
- Nurse Faculty Verification of Employment
- Rural Dental Therapists/Advanced Dental Therapist Confirmation of Practice
- Rural Dental Therapists/Advanced Dental Therapist Verification of Employment
- Rural Mental Health Professional Confirmation of Practice
- Rural Mental Health Professional Verification of Employment
- Rural Pharmacist Confirmation of Practice
- Rural Pharmacist Verification of Employment
- Rural Physician Confirmation of Practice
- Rural Physician Verification of Employment
- Rural Public Health Nurse Confirmation of Practice
- Rural Public Health Nurse Verification of Employment
- Urban Mental Health Professional Confirmation of Practice
- Urban Mental Health Professional Verification of Employment
- Urban Physician Confirmation of Practice
- Urban Physician Verification of Employment
- Urban Advanced Practice Provider Confirmation of Practice (Psychiatric Nurse Practitioner Only)
- Urban Advanced Practice Provider Verification of Employment (Psychiatric Nurse Practitioner Only)
ORHPC Publications
The Office of Rural Health and Primary Care
