Local Health Officer Contact Information Form
To update your Local Health Officer Contact information, please complete the form below. Note: All fields must be completed. An incomplete form will be returned to you to fill-in the missing information. After completing the form, please click on the submit button. The Division of Local Public Health will update your information. If you are required to submit a Letter of Appointment from your town, please email the letter to firstname.lastname@example.org, or by U.S. Mail to Maine Center for Disease Control and Prevention, Division of Local Public Health, 286 Water Street, 7th Floor, SHS 11 Augusta, Maine 04333. Thank you!
If you have any problems using this form, or do not receive a confirmation e-mail, contact Judy Gopaul