Agreement to Provide Consultation - Maine - maine 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the consultant in the designated field at the top of the form. This identifies who will be providing consultation.
3. Select the appropriate box indicating whether the consultant is a Licensed Social Worker Conditional or a Licensed Master Social Worker Conditional Clinical. This choice determines the requirements for consultation hours.
4. Fill out the Consultant Data section with details such as mailing address, license number, and work telephone number. Ensure accuracy for proper communication.
5. Complete the Consultee Data section with similar information about the consultee, including their name and license number if applicable.
6. In the Applicant’s Employment Data section, provide details about the place of employment and beginning date of employment.
7. Both consultant and consultee must sign and date at the bottom of the form to affirm their understanding and acceptance of conditions.

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