Prescriber RxSentry Access Form

Prescribers
Requesting Access to MN Prescription Monitoring Program (PMP)
Terms of Use & Instructions 

 

Access to the Minnesota Prescription Monitoring Program (MN PMP) is granted only with the authority and rights allowed under M.S. 152.126. Access to this data is granted to prescribers, dispensers and agents approved to access the information on their behalf,  to the extent the information relates specifically to a current patient to whom the practitioner is prescribing or dispensing or considering prescribing or dispensing any controlled substance.

Terms of Use of MN PMP Database:

• Authorized users are responsible for all use of their User Id and password.

•  The data obtained from the MN PMP is protected health information and disclosure of MN PMP patient profile data in violation of state or federal laws relating to the privacy of health care data is grounds for disciplinary action by the appropriate health-related licensing board and may also subject the authorized user to civil penalties.

• If the license of the authorized users is restricted by his or her regulatory (licensing) board, their access to the MN PMP database may be immediately terminated. Additionally, should any violations of these terms of use be identified, the MN PMP staff may make an uncontestable revocation of the authorized user’s direct access to the MN PMP database.

• Authorized users must notify the MN PMP staff of changes to their professional credentials, name changes, address changes, or other information which could affect their MN PMP online account access.

To request access to the MN Prescription Monitoring Program (PMP) database, complete the application and return it to the MN PMP office.

Instructions:

Step 1. Complete the “Prescriber’s MN PMP Access Request Form”. The email address you provide will be used to notify you of your personal account log in information.   Please refrain from providing an email address that can be accessed by others.

Step 2. Sign and date the form in the presence of a Notary Public, ensuring the Notary signs that he/she witnessed your signature. Your signature must be notarized as an added precaution against identity theft. Forms that have not been signed in the presence of a notary public will be returned to the applicant.

Step 3. Retain a copy of the “Prescriber’s MN PMP Access Request Form for your records”.

Step 4. Submit the completed form to the MN PMP office via the following:

Fax (651/201-2837)
Scan/email (Minnesota.pmp@state.mn.us)
Mail (To the address shown on the request form)

Upon receipt, the MN PMP staff will verify your credentials and may verify your employment with your employer. Email notifications will be sent once your application is approved.

If you do not receive an email from the MN PMP office within 14 business days after you have submitted your request, check your SPAM folder to see if the email was classified as SPAM; if no response is located, contact the MN PMP Office at 651/201-2836 for assistance.

PRESCRIBER’S ACCESS REQUEST FORM (PDF)