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Home Care & Hospice Alliance of Maine
2025-26 Membership Application
Membership Year: June 1, 2025 - May 31, 2026
*
1.
Contact Information
(Required.)
Name:
Email:
Agency/Company:
Website:
*
2.
Please select type(s) that apply to your agency:
(Required.)
Medicare-Certified Home Health Agency
Medicare-Certified Hospice
State Licensed Home Care Agency
Registered Homemaker/Personal Care
Associate/Allied (provides goods/services but not direct care in the home)
Individual/Sole Proprietor (appropriate for self-employed consultants)