Filer Registration

Required Information*
 

Username*	(e.g. marysmith and case sensitive)
Password*	(8 to 10 characters and case sensitive)
Security Question*	What is your maternal grandfather's nick name? What street did your best friend in high school live on? What was the name of your first pet? What was the make and model of your first car?
Security Answer*
First Name*
Middle Name
Last Name*
Company Name
Your Working Title
Phone Number*
Extension
Email Address*
Note: Your name as registered above will be requested as your signature when you submit a well disclosure certificate.

Where can I get more information or help?

If you have any questions regarding e-Well Disclosure contact the Minnesota Department of Health, Well Management Section Central Office, at health.welldisclosures@state.mn.us or by telephone at 651-201-4587 or 800-383-9808.