Locum Tenens Application

Locum Tenens Application

Please review the attached Executive Orders related to the COVID-19 public health emergency: 

Licensure:       Executive Order 16 FY19/20;

Notarization:   Executive Order 37 FY19/20

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Dear Applicant:

Below please find the link for an application to practice in a Locum Tenens capacity in the State of Maine. Full instructions, the application, the statute governing Locum Tenens licensure in Maine and the credit card payment form are part of the packet. If you have applied previously, please be sure to review the packet as our application and instructions have been updated. The LT application fee is $200 (Note: Application fees are non-refundable).

LT App 4 1 2022.pdf

LT Statute 32 MRS 2574.pdf

CC Payment Authorization Form_4.pdf

To view PDF or Word documents, you will need the free document readers.

You are also welcome to call or e-mail the office (207-287-2480 or osteo.pfr@maine.gov) and request that the packet be mailed to you.