Important: Please read all instructions and information before completing and signing the form. An incomplete form might not be accepted.A signed and dated patient consent is necessary for the records release. Here are some tips for completing the MNsure online application. Fill out and return the MNsure paper application DHS-6696 (PDF). Call the Board of Medical Practice at (612) 6172130 or 18006573709. Telehealth is the delivery of health care services or consultations through the use of real time, twoway interactive audio and visual communications. The purpose of the Minnesota Standard Consent Form is to provide a clear and legal way for individuals to authorize the release of their health information. Treatment Plan This is asking about whether or not the patient is engaging in the care plan that you and the patient have decided on together. Comment when needed with qualifier, limits, or opportunities that you're aware of.