Professional License and Liability Insurance Submissions

Please ensure all documents are current and valid prior to submission

Your First and Last Name(Required)

Email(Required)

Enter Email Confirm Email

Please select the document type(Required)

Professional License

Professional Liability Insurance

Expiration date listed on document(Required)

File(Required)

Max. file size: 50 MB.

Statewide Crisis Line: 1-888-568-1112
National Crisis Line: 988

306 Rodman Road
Auburn, ME 04210

207-333-3278
1-877-888-4304

PO Box 1150
Auburn, ME 04211

207-333-3037

info@healthaffiliatesmaine.com