Minnesota Candor Act Resources

Minnesota Candor Act—Consent and Other Forms

General templates of forms used during the Candor process for the health care community to download and use. PLEASE NOTE: All forms use the language required under the Minnesota Candor Act and any edits should be made and/or reviewed by the proper legal counsel.

• Minnesota Statute 541.076

   A copy of the statute of limitations related to the Minnesota Candor Act, which has to be provided with the Patient Consent to Participate in Candor Open Discussion form.

  Patient Consent to Participate in Candor Open Discussion

  Form that needs to be signed by patient and returned to provider to initiate the Candor process.

  Health Care Provider/Facility Notice for Candor Open Discussion

  Initial form to be completed by provider/facility and sent to patient to notify him/her that the provider/facility would like to utilize the Candor process. This must include the relevant statute referenced in this notice. Copies of this statute (Minnesota Statute 541.076) are available in this section.

  Patient Acknowledgment of Health Care Provider/Facility Advisement and Notice Related to Offer of Compensation

  Notifies the patient of requirements outlined in the Minnesota Candor Act when an offer of compensation is made and the patient is not represented by legal counsel.

  Participation Agreement in a Candor Open Discussion

  Form to be completed by others (e.g., family members, patient’s attorney, etc.) who would like to participate in the Candor discussions alongside the patient.