EmailMe Form - Update Your Employees' Information

Use this form to request changes to your employees' information in our database. If you need to make more updates not described below, please send your changes to membershipupdate@careproviders.org or call 952-854-2844.

PLEASE NOTE: Submitting this form does not automatically update your information on our website. As all database changes need to go through Care Providers of Minnesota staff first, it may take up to a few days for your information to change.

Your name *

First Last

Your email *

(Current, working email address)

Your phone number *

### - ### - ####

Your company/facility/site name *

Your site's corporate entity (if applicable)

Requested Changes

Please fill out any fields below that need changing in our database.

Please select the type of change you wish to make: *

Remove employee(s)

Add employee(s)

Add AND remove employees

Other

Employee Changes

	Name	Title	Email	Note "add" or "remove" if making multiple changes	Facility/site (if different than noted above)
Employee 1
Employee 2
Employee 3
Employee 4
Employee 5
Employee 6
Employee 7
Employee 8
Employee 9
Employee 10

Additional changes/questions/details

If you have any questions, please contact webmaster@careproviders.org