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Attached, please find an application to practice as a Locum Tenens physician in the State of Maine.
The Application must be completed and submitted to the address on the application with notarized photocopies* of both your medical school diploma and a current state license which does not expire for at least the next six months. These documents are required; substitutions will not be accepted unless there is documentation of a specific hardship (i.e., fire). The fee for a Locum Tenens license is $200 (non-refundable) for a 6-month period of up to 6 months.
A letter of need from the hospital or institution requiring your services must be submitted by the hospital or institution directly to this office. The letter must include specific dates, not to exceed 6 months.
The Application for Locum Tenens is in Adobe format. If you do not have Adobe Acrobat Reader you can download if for free at www.adobe.com or you can call the office at the number listed below and we will send an application to you. In addition, the statute governing the licensing of Locum Tenens osteopathic physicians in Maine can be found at http://janus.state.me.us/legis/statutes/32/title32sec2574-1.html.
Please feel free to contact me at (207) 287-2480 if you have any questions regarding this application. If I am unable to take your call, please leave a message and I'll get back to you as soon as possible.
Susan E. Strout
*Documents must have a statement from the Notary Public (not the applicant) indicating that he/she has seen the original and that ‘this is a true copy of the original’. Incomplete notarizations will be returned. Faxed copies will not be accepted.
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