Maine Community Health Worker (MECHW) Recertification Application

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This application form will allow you to apply for the certification status listed below by providing a way to upload the required documentation and pay the required assessment fee. Please have the documentation and payment ready in order to complete the application. Refer to the MECHW website for additional information regarding the requirements. MECHW Certification Website

Recertification (Fee $75) Required Documentation:

40 hours of continuing education
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Full Name* This field is required.
First Name
Last Name
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Email Address* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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I have completed 40 continuing education (CE) hours.* This field is required.Candidate must complete a minimum of 40 CE hours. Please see the website for additional information. MECHW Certification Website.
Yes
No
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I attest that I have read and accept the MECHW Code of Ethics.* This field is required.Candidate must attest to the MECHW code of ethics. Please click here to review the code of ethics CHW Code if Ethics
Yes
No
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Please upload all required documentation.* This field is required.40 hours of continuing education
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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All documentation must be uploaded in order to apply. Indicate the documents that you have uploaded by checking the boxes below.
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Fees* This field is required.
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MECHW Recertification Fee
Recertification Fee
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By signing below, you confirm that all information provided is accurate, and if required, all documentation has been uploaded.* This field is required.
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You do not currently meet the application requirements. Please refer to the Maine Community Health Workers website for specific application requirements.
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