Crisis Form V2 2014.Xls Computer System to Gather Crisis Data It Must Comply with This Rule: If Et, Then the Data in the Drop Downs Must Be Used Verbatim for Answers

Summary of Telephone Crisis Contacts Total number telephone contacts Children

Total number telephone contacts Adults

All Encounters. Is this an Initial or Follow up Face To Face Encounter. REQUIRED.

Type Of Encounter

Number

If an alternative spreadsheet is developed on your c there are drop downs for an item in the spreadshee

All Encounters. Enter your Agencies Name from All Encounters. Select a report year from drop down. REQUIRED. drop down. REQUIRED.

Agency Name Report Year

Questions or concerns: Lee Richardson at 287-4591 or Julia Mason at 287-6667 Crisis Form V2_2014.xls computer system to gather Crisis Data it must comply with this rule: If et, then the data in the drop downs must be used verbatim for answers

All Encounters. Select a report All Encounters. Enter All Encounters. Enter month from drop down. clients first name. clients last name. REQUIRED. REQUIRED. REQUIRED.

Report Month First Name Last Name

All Encounters. Select a Town from the List. All Encounters. Enter the clients REQUIRED. Medicaid ID.

Town Zip Medicaid Id

All Encounters. Select a Payment Source from the drop down. All Encounters. Enter an SSN with REQUIRED. no dashes.

Payment Source SSN

All Encounters. Select clients All Encounters. Enter the date All Encounters. Enter clients Gender from drop down. the Crisis worker met with Date Of Birth. REQUIRED. REQUIRED. client. REQUIRED.

DOB Gender Date Of Encounter

Initial Encounters only. New for Initial Encounters only. New for 2014. REQUIRED. 2014. REQUIRED.

Housing status at time of the Who made the request for initial encounter encounter

All Encounters. Select from drop down where the Crisis Worker All Encounters. New for 2015 - met with the client this encounter. REQUIRED. REQUIRED.

Did the assessment from this encounter indicate the client would benefit from Site Of Face To Face Encounter substance abuse treatment.

Initial Encounters only. Select from drop down a Crisis Assessment Criteria. REQUIRED

Crisis Assessment Criteria

All Encounters. Select Yes, No or NA from the drop down. If the client is not over 18 select NA. REQUIRED.

If this client is under 18 do they have a MENTAL RETARDATION/AUTISM/PERVASIVE/Developmental DISORDER.

All Encounters. Select Yes, No from the drop down. Same as on All Encounters. Select Yes, No from the old form - REQUIRED drop down. REQUIRED Is this Crisis Encounter the result Does this client have a wellness plan, crisis of an on going support for a plan, ISP or advanced directive plan previous crisis previously developed that was used for this resolution/stabilization. encounter.

All Encounters. Select Yes, No or NA from the drop down. Select NA if the All Encounters. Select Yes, No client did not have a Community Support from the drop down. REQUIRED worker. REQUIRED

Does this client have a Community If the client had a Community Support Support Worker (CI, CRS, ICM, Worker, was that worker notified of the ACT, TCM) crisis.

Initial Encounters Only. Enter time in Initial Encounters Only. Enter time in Minutes as Hours as a whole number. Round minutes a whole number. REQUIRED off. Must be at least 1. REQUIRED Time in MINUTES between determination of need for initial face to face contact or when client Time in HOURS from initial Face to Face was ready and able to be seen, to initial face to Encounter to Disposition of Crisis. face contact

Follow Up Encounters Only. Enter time in All Encounters. Select Yes, No or Hours as a whole number. Round minutes NA from the drop down. off. Must be at least 1. REQUIRED REQUIRED

Time in HOURS for Non Initial Face to If this client is under 18 are they Face Encounter in State Custody?

Initial Encounters only. Select from drop down a Crisis Resolution. REQUIRED

Crisis Resolution (Mutually Exclusive and Exhaustive)

Form Data

Site Of Face To Face Encounter

Primary Residence (Home) Family/Relative/Other Residence Other Community Setting (Work, School, Police Dept, Public Place) SNF, Nursing Home, Boarding Home Residential Program (Congregate Community Residence, Apartment Program) Homeless Shelter Provider Office Crisis Office Emergency Department Other Hospital Location Incarcerated (Local Jail, State Prison, Juvenile Correction Center)

Crisis Assessment Criteria

Depression Anxiety Behavioral Issues--youth Suicidal Ideation Suicidal Act Psychosis Homicidal Ideation Homicidal Act Self-Injury/Assaultive Behavior Substance Abuse Medical Attention needed Mental Health Symptom Decompensating Grief and Loss Domestic Abuse Acute Stress No medical Based Change in Mental Status Sexual Assault Overdose Inability to care for self

Crisis Resolution.

Crisis Stabilization with no referrals for Mental health/substance abuse follow-up. Crisis Stabilization with referral to new provider for Mental Health/Substance Abuse follow-up. Crisis Stabilization with referral back to current provider for Mental Health/Substance Abuse follow-up. Admission to Crisis Stabilization unit. Inpatient Hospitalization - Medical. Voluntary Psychiatric Hospitalization. Involuntary Psychiatric Hospitalization. Admission to Detox Unit.

Town Zip Agency Name ABBOT VILLAGE 04406 AMHC ACTON 04001 Community Health and Counseling ADDISON 04606 Maine Behavioral Healthcare - Biddeford ALBANY 04267 Crisis & Counseling Centers, Inc. ALBANY 04231 Evergreen Behavioral Services ALBION 04910 Oxford County Mental Health Services ALFRED 04002 Maine Behavioral Healthcare - Rockland ALLENS MILLS 04938 Sweetser ALNA 04535 The Opportunity Alliance ALTON 04468 Tri-County Mental Health Services AMHERST 04605 AMITY 04465 ANDOVER 04216 ANSON 04911 APPLETON 04862 ARROWSIC 04530 ARUNDEL 04005 ARUNDEL 04046 ASHLAND 04759 ASHLAND 04737 ASHLAND 04732 ASHVILLE 04607 ATHENS 04912 ATKINSON 04410 ATKINSON 04426

ATKINSON CORNER 04426 AUBURN 04210 AUGUSTA 04330 AURORA 04408 AURORA 04605 AVON 04966 AYERS 04666 BAILEY ISLAND 04003 BAILEYVILLE 04694 BALDWIN 04024 BANCROFT 04497 BANCROFT 04424 BANGOR 04401 BAR HARBOR 04609 BAR MILLS 04004 BARING 04694 BARNARD 04414 BASS HARBOR 04653 BATH 04530 BAYSIDE 04605 BAYSIDE 04915 BAYVILLE 04536 BEAR ISLAND 04683 BEDDINGTON 04622 BELFAST 04915 BELGRADE 04917 BELGRADE LAKES 04918 BELMONT 04952 BELMONT 04915

BELMONT CORNER 04915 BENEDICTA 04733 BENTON 04910 BENTON 04936 BENTON FALLS 04901 BENTON STATION 04937 BERNARD 04612 BERWICK 03901 BETHEL 04217 BIDDEFORD 04005 BIDDEFORD POOL 04006 BINGHAM 04920 BIRCH HARBOR 04613 BIRCH ISLAND 04011 BLAINE 04758 BLANCHARD 04406 BLUE HILL 04614 BLUE HILL FALLS 04615 BOLSTERS MILLS 04040 BOOTHBAY 04549 BOOTHBAY 04537 BOOTHBAY HARBOR 04536 BOOTHBAY HARBOR 04570 BOOTHBAY HARBOR 04538 BOWDOIN 04350 BOWDOINHAM 04252 BOWDOINHAM 04008 BOWERBANK 04426 BOYD-LAKE 04463 BRADFORD 04410

BRADFORD CENTER 04410 BRADLEY 04412 BREWER 04412 BREWER LAKE 04474 BRIDGEWATER 04735 BRIDGTON 04009 BRIGHTON 04912 BRIGHTON 04990 BRISTOL 04539 BROOKLIN 04616 BROOKS 04921 BROOKSVILLE 04617 BROOKTON 04413 BROWNFIELD 04010 BROWNVILLE 04414 BRUNSWICK 04053 BRUNSWICK 04011 BRUNSWICK NAVAL AIR STATION 04011 BRYANT POND 04219 BUCKFIELD 04220 BUCKS HARBOR 04618 BUCKSPORT 04416

BUNKERS HARBOR 04613 BURKETTVILLE 04574 BURLINGTON 04417 BURNHAM 04922 BUSTINS ISLAND 04013 BUXTON 04093 BUXTON CENTER 04093 BYRON 04275 CALAIS 04619 CAMBRIDGE 04923 CAMDEN 04843 CAMDEN 04847 CAMP ELLIS 04072 CANAAN 04924 CANTON 04221 CANTON POINT 04221 CAPE COTTAGE 04107 CAPE ELIZABETH 04107 CAPE JELLISON 04981 CAPE NEDDICK 03902 CAPE PORPOISE 04014 CAPE ROSIER 04642 CAPE SPLIT 04606 CAPITOL ISLAND 04538 CARATUNK 04925 CARDVILLE 04418 CARIBOU 04736 CARMEL 04419 CARRABASSET VALLEY 04947 CARRABASSETT 04947 CARROLL 04487 CARSON 04786 CARTHAGE 04224

CARY PLANTATION 04465 CASCO 04015 CASTLE HILL 04732 CASTLE HILL 04757 CASWELL 04750 CEDAR GROVE 04342

CENTER LEBANON 04027 CENTER LOVELL 04016 CENTER MONTVILLE 04941 CENTER VASSALBORO 04989 CENTERVILLE 04623 CENTRAL M E POWER CO 04336 CHAMBERLAIN 04541 CHAPMAN 04757 CHARLESTON 04422 CHARLOTTE 04666 CHEBEAGUE ISLAND 04017 CHELSEA 04345 CHELSEA 04330 CHERRYFIELD 04622 CHESTER 04458 CHESTERVILLE 04352 CHESTERVILLE 04938 CHESTERVILLE 04955

CHESUNCOOK DAM 04441 CHESUNCOOK VILLAGE 04441 CHINA 04358 CHISHOLM 04239 CHRISTMAS COVE 04568 CLARK ISLAND 04859 CLAYTON LAKE 04737 CLAYTON LAKE 04732 CLIFF ISLAND 04019 CLIFTON 04428

CLIFTON CORNERS 04428 CLINTON 04927 COBURN GORE 04936 CODYVILLE 04490 COLBY 04736 COLBY COLLEGE 04901 COLES CORNER 04496 COLUMBIA 04623 COLUMBIA 04643 COLUMBIA FALLS 04623 CONCORD 04979 CONNORS 04736 COOKS CORNER 04011 COOPERS MILLS 04341 COPLIN 04982 COREA 04624 CORINNA 04928 CORINNA CENTER 04928 CORINTH 04427 CORNISH 04020 CORNVILLE 04976 COSTIGAN 04423 COUSINS ISLAND 04096 CRAWFORD 04694 CROUSEVILLE 04786 CRYSTAL 04747 CUMBERLAND 04021 CUMBERLAND CENTER 04021 CUMBERLAND FORESIDE 04110 CUMBERLAND MILLS 04092 CUNDYS HARBOR 04011 CUPSUPTIC 04964 CUSHING 04563 CUTLER 04626

CUTLER NAVAL COMMUNICATIONS 04630 CUTTS ISLAND 03905 CYR PLANTATION 04785 DAIGLE 04743 DALLAS 04970 DAMARISCOTTA 04543 DAMASCUS 04419 DANFORTH 04492 DANFORTH 04424 DANVILLE 04223 DAYTON 04005 DEBLOIS 04622 DEDHAM 04429 DEER ISLE 04627 DENMARK 04022 DENNISTOWN 04945 DENNYSVILLE 04628 DERBY 04463 DETROIT 04929 DEXTER 04930 DICKEY 04774 DIXFIELD 04224 DIXMONT 04932 DIXMONT CENTER 04932 DOLBY 04430 DORMAN 04643 DOUGLAS HILL 04024 DOVER 04426

DOVER-FOXCROFT 04426 DRESDEN 04342 DREW 04497 DRY MILLS 04039 DRYDEN 04225 DUCKTRAP 04849 DURHAM 04032 DURHAM 04252 DURHAM 04069 DURHAM 04210 DYER BROOK 04747 E PLANTATION 04758 EAGLE ISLAND 04683 EAST ANDOVER 04226 EAST AUBURN 04210 EAST BALDWIN 04024 EAST BENTON 04910 EAST BETHEL 04217 EAST BOOTHBAY 04544 EAST BUCKFIELD 04220 EAST CORINTH 04427 EAST DENMARK 04022 EAST DIXFIELD 04227 EAST DIXMONT 04932 EAST DOVER 04426 EAST EDDINGTON 04428 EAST EDGECOMB 04556 EAST EXETER 04427 EAST FRANKLIN 04634 EAST FRIENDSHIP 04547 EAST FRYEBURG 04010 EAST HAMPDEN 04444 EAST HARPSWELL 04011 EAST HIRAM 04041 EAST HOLDEN 04429 EAST HOLDEN 04412 EAST KNOX 04986 EAST LAMOINE 04605 EAST LEBANON 04027 EAST LIMINGTON 04085 EAST LIVERMORE 04228 EAST LOWELL 04433 EAST MACHIAS 04630 EAST MADISON 04976

EAST MILLINOCKET 04430 EAST NEW PORTLAND 04961 EAST NORTHPORT 04915 EAST ORLAND 04431 EAST ORRINGTON 04474 EAST OTISFIELD 04270 EAST PALERMO 04354

EAST PARSONFIELD 04028 EAST PERU 04229 EAST PITTSTON 04345 EAST POLAND 04230 EAST RUMFORD 04276 EAST SEBAGO 04029 EAST STONEHAM 04231 EAST SULLIVAN 04607 EAST SUMNER 04220 EAST SURRY 04605 EAST THORNDIKE 04986 EAST TROY 04987

EAST WATERBORO 04030 EAST WATERFORD 04233 EAST WILTON 04234 EAST WINDHAM 04082 EAST WINN 04455 EAST WINTHROP 04343 EASTBROOK 04634 EASTON 04740 EASTON CENTER 04740 EASTPORT 04631 EATON 04424 EDDINGTON 04428 EDDINGTON 04412 EDGECOMB 04556 EDINBURG 04448 EDMUNDS TOWNSHIP 04628 EGGEMOGGIN 04650 EGYPT 04605 ELIOT 03903 ELLIOTTSVILLE 04464 ELLSWORTH 04605

ELLSWORTH FALLS 04605 EMBDEN 04979 EMBDEN 04958 EMERY MILLS 04031 ENFIELD 04433 ESTABROOK SETTLEMENT 04465 ETNA 04434 ETNA CENTER 04434 EUSTIS 04936 EXETER 04435 EXETER CENTER 04435 EXETER CORNER 04435 EXETER MILLS 04427 EXETER MILLS 04435 FAIRBANKS 04938 FAIRFIELD 04937

FAIRFIELD CENTER 04937 FAIRMOUNT 04742 FALMOUTH 04105 FALMOUTH FORESIDE 04105 FARMINGDALE 04345 FARMINGTON 04938 FAYETTE 04352 FAYETTE 04349 FERRY BEACH 04072 FIVE ISLANDS 04546 FLETCHERS LANDING 04605 FOREST CITY 04413 FORT FAIRFIELD 04742 FORT KENT 04743 FORT KENT VILLAGE 04743 FOXCROFT 04426 FRANKFORT 04438 FRANKLIN 04634 FREEDOM 04941 FREEMAN 04983 FREEPORT 04032 FRENCHBORO 04635 FRIENDSHIP 04547 FRYE 04235 FRYEBURG 04037 GARDINER 04345 GARFIELD 04732 GEORGETOWN 04548 GERRISHVILLE 04693 GERRY 04468 GILEAD 04217 GLEN COVE 04846 GLENBURN 04401 GLENBURN 04449

GLENBURN CENTER 04401 GLENWOOD 04497 GOOSE ROCKS BEACH 04046 GORHAM 04038 GOTTS ISLAND 04653 GOULDSBORO 04607 GRAND FALLS 04417 GRAND ISLE 04746 GRAY 04039 GREAT FALLS 04210 GREAT SPRUCE HEAD ISLAND 04683 GREAT WORKS 04468

GREELEY LANDING 04426 GREEN LAKE 04429 GREENBUSH 04423 GREENE 04236 GREENFIELD 04423 GREENVILLE 04441 GREENVILLE 04485 GREENVILLE JUNCTION 04442 GREENWOOD 04289 GRINDSTONE 04460

GRINDSTONE NECK 04693 GROVEVILLE 04038 GUERETTE 04783 GUILFORD 04443 GUILFORD 04482 HALL QUARRY 04660 HALLDALE 04986 HALLOWELL 04347 HAMLIN 04785 HAMMOND 04730 HAMPDEN 04444 HAMPDEN HIGHLANDS 04444 HANCOCK 04640 HANCOCK POINT 04640 HANOVER 04237 HARBOR ISLANDS 04109 HARBORSIDE 04642 HARMONY 04942 HARPSWELL 04079 HARRINGTON 04643 HARRISON 04040 HARTFORD 04220 HARTFORD 04221 HARTLAND 04943 HAYNESVILLE 04446 HEBRON 04238 HERMON 04401 HERMON 04419 HERMON CENTER 04401 HERON ISLAND 04568 HERSEY 04747 HERSEY 04765 HIGGINS BEACH 04074 HIGHLAND 04961 HIRAM 04041 HOLDEN 04429 HOLLIS 04042 HOLLIS CENTER 04042 HOPE 04847 HOUGHTON 04275 HOULTON 04730 HOWES CORNERS 04969 HOWLAND 04448

HOWLAND CENTER 04448 HOYTTOWN 04654 HUDSON 04449 HUDSON 04450 INDIAN POINT 04660 INDIAN RIVER 04606 INDIAN TOWNSHIP INDIAN RESER 04668 INDUSTRY 04938 ISLAND FALLS 04747 ISLE AU HAUT 04645 ISLE OF SPRINGS 04549 ISLESBORO 04848 JACKMAN 04945

JACKMAN STATION 04945 JACKSON 04921 JACKSONVILLE 04630 JAY 04239 JAY 04262 JEFFERSON 04348 JONESBORO 04648 JONESPORT 04649 KEEGAN 04785 KENDUSKEAG 04456 KENDUSKEAG 04450 KENDUSKEAG 04401

KENNEBAGO LAKE 04970 KENNEBEC 04654 KENNEBUNK 04043

KENNEBUNK BEACH 04043

KENNEBUNKPORT 04046

KENNEBUNKPORT 04014 KENTS HILL 04349 KEZAR FALLS 04047 KINGFIELD 04947 KINGMAN 04451 KINGSBURY 04990 KITTERY 03904 KITTERY POINT 03905

KNOWLES CORNER 04780 KNOX 04921 KNOX 04941 KNOX 04952 KNOX 04986 KNOX CENTER 04986 KOKADJO 04441 L L BEAN CO 04033 LA GRANGE 04453 LAGRANGE 04453 LAKE MOXIE 04985 LAKE VIEW 04463 LAKEVILLE PLANTATION 04487 LAKEWOOD 04976 LAMOINE 04605 LARONE 04937 LARRABEE 04655 LAWRY 04547 LEBANON 04027 LEE 04455 LEEDS 04263 LEVANT 04456 LEWISTON 04240 LEXINGTON 04961 LIBERTY 04949 LILLE 04749 LIMERICK 04048 LIMESTONE 04751 LIMESTONE 04750 LIMINGTON 04049 LINCOLN 04457 LINCOLN CENTER 04458 LINCOLNS MILLS 04928 LINCOLNVILLE 04849 LINCOLNVILLE BEACH 04849 LINCOLNVILLE CENTER 04850 LINNEUS 04730 LISBON 04250 LISBON CENTER 04251 LISBON FALLS 04252 LITCHFIELD 04350 LITTLE DEER ISLE 04650 LITTLE MACHIAS 04626 LITTLETON 04760 LITTLETON 04730 LIVERMORE 04253

LIVERMORE FALLS 04254 LOCKE MILLS 04255 LONG ISLAND 04050 LONG ISLAND 04635 LORING A F B 04751 LORING AFB 04751 LORING AIR FORCE BASE 04751 LOVELL 04051 LOWELL 04433 LOWER DENNYSVILLE 04628 LUBEC 04652

LUCERNE IN MAINE 04429

LUCERNE-IN-MAINE 04429 LUDLOW 04730 LYMAN 04005 LYNCHVILLE 04231 MAC MAHAN 04546 MACHIAS 04686 MACHIAS 04654 MACHIASPORT 04655 MACWAHOC 04451 MADAWASKA 04756

MADAWASKA LAKE 04783 MADISON 04950 MADRID 04966 MAINE MARITIME ACADEMY 04420 MAINSTREAM 04942 MANCHESTER 04351 MANSET 04679 MANSET 04656 MAPLE GROVE 04742 MAPLETON 04757 MAPLEWOOD 04095 MARIAVILLE 04605

MARION TOWNSHIP 04628 MARLBORO 04605 MARS HILL 04758 MARSHFIELD 04654 MARSHVILLE 04643 MARTIN 04547 MARTINSVILLE 04860 MASARDIS 04759 MATINICUS 04851 MATTAWAMKEAG 04459 MAXFIELD 04463 MAXFIELD 04453 MAYFIELD 04990 ME STATE AGENCIES 04333 MECHANIC FALLS 04256 MEDDYBEMPS 04657 MEDFORD 04453 MEDFORD 04463 MEDOMAK 04551 MEDWAY 04460 MERCER 04957 MEREPOINT 04053 MERRILL 04780 MEXICO 04257 MIDDLEDAM 04216 MILBRIDGE 04658 MILFORD 04461 MILL ISLAND 04683 MILLINOCKET 04462 MILLONOCKET CENTER 04462 MILLTOWN 04619 MILO 04463 MINOT 04258 MOLUNKUS 04451 MONARDA 04776 MONHEGAN 04852 MONMOUTH 04259 MONROE 04951 MONROE CENTER 04921 MONSON 04464 MONTICELLO 04760 MONTVILLE 04941 MONTVILLE 04952 MONTVILLE 04986 MOODY 04054 MOODY BEACH 04054 MOOSE RIVER 04945 MOOSEHEAD 04442 MORO 04780 MORRILL 04952 MORRILL 04915 MOSCOW 04920 MOUNT CHASE 04765 MOUNT DESERT 04660 MOUNT VERNON 04352 NAPLES 04055 NASHVILLE 04732 NASKEAG 04616 NAVAL AIR STATION 04011 NEADEAUVILLE 04459 NEW AUBURN 04210 NEW CANADA 04743

NEW GLOUCESTER 04260 NEW HARBOR 04554 NEW MEADOWS 04530 NEW PORTLAND 04954 NEW SHARON 04955 NEW SWEDEN 04762 NEW VINEYARD 04956 NEWAGEN 04552 NEWBURGH 04932 NEWBURGH 04444 NEWBURGH 04419 NEWCASTLE 04553 NEWFIELD 04056 NEWPORT 04953 NEWRY 04261 NOBLEBORO 04555 NORRIDGEWOCK 04957 NORTH AMITY 04465 NORTH ANSON 04958 NORTH AUBURN 04210 NORTH BALDWIN 04024

NORTH BANCROFT 04424 NORTH BANGOR 04401 NORTH BATH 04530 NORTH BERWICK 03906 NORTH BETHEL 04217 NORTH BLUE HILL 04614

NORTH BRADFORD 04410 NORTH BREWER 04412 NORTH BRIDGTON 04057

NORTH BROOKLIN 04661 NORTH BROOKSVILLE 04617

NORTH BUCKFIELD 04220 NORTH CARMEL 04419 NORTH CASTINE 04472 NORTH CHESTERVILLE 04938 NORTH CUTLER 04626 NORTH CUTLER 04630 NORTH DIXMONT 04932

NORTH EAST CARRY 04478

NORTH EDGECOMB 04556

NORTH ELLSWORTH 04605 NORTH FAIRFIELD 04937

NORTH FRYEBURG 04058 NORTH GRAY 04039 NORTH GUILFORD 04443

NORTH HARPSWELL 04079 NORTH HAVEN 04853 NORTH JAY 04262 NORTH LEBANON 04027 NORTH LEEDS 04263

NORTH LIMINGTON 04085

NORTH LIVERMORE 04254 NORTH LOVELL 04231 NORTH LUBEC 04652 NORTH LYNDON 04736

NORTH MONMOUTH 04265 NORTH MONROE 04951 NORTH NEW PORTLAND 04961 NORTH NEWPORT 04928 NORTH ORLAND 04429

NORTH ORRINGTON 04474 NORTH PALERMO 04354 NORTH PARIS 04289 NORTH PARSONFIELD 04047

NORTH PENOBSCOT 04476 NORTH PERRY 04667 NORTH PITTSTON 04345 NORTH POWNAL 04069 NORTH SCARBOROUGH 04074

NORTH SEARSMONT 04915

NORTH SEARSPORT 04974 NORTH SEBAGO 04029

NORTH SEDGWICK 04676

NORTH SHAPLEIGH 04060 NORTH SULLIVAN 04689 NORTH TURNER 04266 NORTH VASSALBORO 04962 NORTH WADE 04786 NORTH WALDOBORO 04572 NORTH WATERBORO 04061 NORTH WATERFORD 04267 NORTH WAYNE 04284

NORTH WHITEFIELD 04353 NORTH WINDHAM 04062

NORTH YARMOUTH 04069

NORTH YARMOUTH 04096

NORTH YARMOUTH 04021 NORTHFIELD 04654 NORTHPORT 04915 NORTHPORT 04849 NORUMBEGA 04617 NORWAY 04268 NOTRE DAME 04749 OAKFIELD 04763 OAKLAND 04963 OCEAN PARK 04063 OCEAN POINT 04544 OCEANVILLE 04681 OGONTZ 04478 OGUNQUIT 03907 OLAMON 04467 OLD ORCHARD BEACH 04064 OLD ORCHARD BEACH 04063 OLD TOWN 04468 ONAWA 04464 OOB 04064 OQUOSSOC 04964 ORIENT 04471 ORLAND 04472 ORNVILLE 04463 ORONO 04473 ORRINGTON 04412 ORRINGTON 04474 ORRINGTON CENTER 04474 ORRS ISLAND 04066 OSBORN 04605 OTIS 04605 OTISFIELD 04040 OWLS HEAD 04854 OXBOW 04764 OXFORD 04270 PACKARDS LANDING 04443 PALERMO 04354 PARIS 04271 PARIS HILL 04271 PARKMAN 04443 PARKMAN 04923 PARSONFIELD 04048 PARSONSFIELD 04028 PASSADUMKEAG 04475 PATTEN 04765 PEAKS ISLAND 04108 PEJEPSCOT 04067 PEMAQUID 04558 PEMAQUID BEACH 04554

PEMAQUID HARBOR 04558 PEMBROKE 04666 PENOBSCOT 04476 PENOBSCOT INDIAN RESERVATION 04468 PERRY 04667 PERU 04272

PETER DANA POINT 04668 PHILLIPS 04966 PHIPPSBURG 04567 PHIPPSBURG 04562 PINE POINT 04074 PITTSFIELD 04967 PITTSTON 04345 PITTSTON FARM 04478 PLANTATION 8 04605 PLEASANT POINT 04667 PLEASANT POND 04925 PLEASANT RIDGE 04920 PLYMOUTH 04969 PLYMOUTH 04932 POLAND 04273 POLAND SPRING 04274 POND COVE 04107 POPHAM BEACH 04562 PORT CLYDE 04855 PORTER 04068 PORTERFIELD 04047 PORTLAND 04106 PORTLAND 04105 PORTLAND 04103 PORTLAND 04107 PORTLAND 04101 PORTLAND 04100 PORTLAND 04102 PORTLAND 04109 PORTLAND 04110 PORTLAND 04108 POWNAL 04069 POWNAL CENTER 04069 PRENTISS 04487 PRESQUE ISLE 04769 PRETTY MARSH 04660 PRINCETON 04668 PROSPECT 04981 PROSPECT 04438 PROSPECT FERRY 04981

PROSPECT HARBOR 04669 PROUTS NECK 04074 PULPIT HARBOR 04853 RANDOLPH 04347 RANDOLPH 04345 RANGELEY 04970 RAYMOND 04071 RAZORVILLE 04574 READFIELD 04355 RED BEACH 04619 REED 04497 RICHMOND 04357 RIPLEY 04930 RIPLEY 04643 RIPOGENUS DAM 04441 ROBBINSTON 04671 ROBINSON 04758 ROCKLAND 04841 ROCKPORT 04856 ROCKWOOD 04478 ROME 04957 ROME 04352 ROME 04963 ROME 04955 ROQUE BLUFFS 04648 ROQUE BLUFFS 04654 ROUND POND 04564 ROXBURY 04275 RUMFORD 04276

RUMFORD CENTER 04278 RUMFORD POINT 04279 SABATTUS 04280

SABBATHDAY LAKE 04274 SACO 04072 SAINT AGATHA 04772 SAINT ALBANS 04971 SAINT DAVID 04773 SAINT FRANCIS 04774 SAINT GEORGE 04857 SALEM 04983 SANDY RIVER 04970 SANFORD 04073 SANGERVILLE 04479 SARGENTVILLE 04673 SCARBOROUGH 04074 SEAL COVE 04674 SEARSMONT 04915 SEARSMONT 04973 SEARSPORT 04974 SEAWALL 04656 SEAWALL 04679 SEBAGO 04029 SEBAGO LAKE 04075

SEBASCO ESTATES 04565 SEBEC 04463 SEBEC CORNERS 04426 SEBEC LAKE 04482 SEBEC LAKE 04443 SEBEC STATION 04426 SEBOOMOOK 04478 SEDGWICK 04676 SHAKER VILLAGE 04274 SHAPLEIGH 04076

SHEEPHEAD ISLAND 04683 SHEEPSCOTT 04578 SHERMAN 04776 SHERMAN MILLS 04776 SHERMAN STA 04777

SHERMAN STATION 04777 SHIN POND 04765 SHIRLEY 04485 SHIRLEY MILLS 04485 SIDNEY 04963 SIDNEY 04330 SILVER RIDGE 04776 SINCLAIR 04779 SKOWHEGAN 04976 SKOWHEGON 04924 SMALL POINT 04567 SMITHVILLE 04680 SMYRNA 04780 SMYRNA CENTER 04780 SMYRNA MILLS 04780 SOLDIER POND 04781 SOLON 04979 SOMERVILLE 04341 SOMERVILLE 04354 SOMERVILLE 04348 SOMESVILLE 04660 SORRENTO 04677 SOUTH ADDISON 04606 SOUTH ANDOVER 04216 SOUTH ARM 04216

SOUTH BANCROFT 04424 SOUTH BERWICK 03908 SOUTH BLUE HILL 04615 SOUTH BREWER 04412 SOUTH BRIDGTON 04009 SOUTH BRISTOL 04568 SOUTH BROOKSVILLE 04617 SOUTH BUXTON 04038 SOUTH CASCO 04077 SOUTH CHINA 04358 SOUTH DEER ISLE 04681 SOUTH DOVER 04426 SOUTH DURHAM 04032 SOUTH ELIOT 03903 SOUTH ETNA 04434 SOUTH EXETER 04928 SOUTH FREEPORT 04078 SOUTH FREEPORT 04013 SOUTH GARDINER 04359 SOUTH GORHAM 04038 SOUTH GOULDSBORO 04678 SOUTH GRAY 04039

SOUTH HARPSWELL 04079 SOUTH HIRAM 04080 SOUTH HOLLIS 04042 SOUTH HOPE 04862

SOUTH LAGRANGE 04453 SOUTH LEBANON 04027 SOUTH LEVANT 04456 SOUTH LEWISTON 04240 SOUTH LIBERTY 04949

SOUTH LIMINGTON 04048 SOUTH LINCOLN 04457

SOUTH LIVERMORE 04254 SOUTH LUBEC 04652 SOUTH MONMOUTH 04259

SOUTH MONTVILLE 04949 SOUTH ORLAND 04472

SOUTH ORRINGTON 04474 SOUTH PARIS 04281 SOUTH PARSONSFIELD 04048

SOUTH PENOBSCOT 04476

SOUTH PORTLAND 04106

SOUTH PRINCETON 04668 SOUTH RANGELEY 04964 SOUTH RUMFORD 04276 SOUTH SANFORD 04073 SOUTH SEBEC 04426 SOUTH SURRY 04684

SOUTH THOMASTON 04858 SOUTH TRESCOTT 04652 SOUTH WALDOBORO 04572

SOUTH WATERFORD 04081 SOUTH WINDHAM 04082 SOUTH WINDSOR 04363

SOUTH WOODVILLE 04458 SOUTHPORT 04576 SOUTHWEST HARBOR 04679 SOUTHWEST HARBOR 04656 SOUTHWEST HARBOR COAST GUARD 04679 SPRAGUEVILLE 04769 SPRINGFIELD 04487 SPRINGVALE 04083 SPRUCE HEAD 04859 SPRUCE POINT 04538 SQUA PAN 04732 SQUIRREL ISLAND 04570 SQUIRREL ISLAND 04538 STANDISH 04084 STARBOARD 04618 STARKS 04911 STEEP FALLS 04085 STETSON 04488 STEUBEN 04680 STOCKHOLM 04783

STOCKTON SPRINGS 04981 STONEHAM 04231 STONINGTON 04645 STONINGTON 04681 STOW 04058 STRATTON 04982 STRONG 04983 SULLIVAN 04634 SULLIVAN 04689 SUMNER 04220 SUMNER 04292 SUNSET 04683 SUNSHINE 04627 SURRY 04684 SURRY 04605 SWANVILLE 04915 SWANVILLE 04438 SWEDEN 04762 SWEDEN 04040 TALMADGE 04492 TEMPLE 04984

TENANTS HARBOR 04860 THE FORKS 04985 THOMASTON 04861 THORNDIKE 04986 THORNDIKE CENTER 04986 TIBBETTSTOWN 04623 TOGUS 04330 TOPSFIELD 04490 TOPSHAM 04086 TREMONT 04653 TRENTON 04605 TREVETT 04571 TROUTDALE 04985 TROY 04987 TROY CENTER 04987 TURNER 04282 TURNER 04283 TURNER CENTER 04283 UNION 04862 UNION MUTUAL LIFE INS 04122 UNION MUTUAL LIFE INS 04123 UNION MUTUAL LIFE INS 04124 UNIONVILLE 04622 UNITY 04988 UNITY COLLEGE 04988 UNIVERSITY OF MAINE 04473 UNIVERSITY OF MAINE 04469 UPPER ABBOT 04406 UPTON 04261 VAN BUREN 04785 VASSALBORO 04989 VEAZIE 04401 VERONA 04416 VIENNA 04360 VINALHAVEN 04863 WADE 04786 WAITE 04424 WAITE 04492 WALDO 04952 WALDO 04921 WALDO 04915 WALDOBORO 04572 WALES 04259 WALES 04280 WALLAGRASS 04781 WALPOLE 04573 WALTHAM 04605 WALTHAM 04634 WARREN 04864 WASHBURN 04786 WASHINGTON 04574 WATERBORO 04087 WATERBORO CENTER 04030 WATERFORD 04088 WATERVILLE 04901 WAVERLY 04967 WAYNE 04284 WEBSTER PLANTATION 04487 WEEKS MILLS 04955 WEEKS MILLS 04361 WELD 04285 WELLINGTON 04990 WELLS 04090 WELLS BEACH 04090 WESLEY 04686 WEST APPLETON 04949 WEST ATHENS 04912 WEST AUBURN 04210 WEST BALDWIN 04091 WEST BATH 04530 WEST BETHEL 04286 WEST BOOTHBAY HARBOR 04575 WEST BOWDOIN 04287 WEST BRIDGTON 04009

WEST BROOKSVILLE 04617 WEST BUXTON 04093

WEST CHARLESTON 04422 WEST CORINTH 04427 WEST CUMBERLAND 04021 WEST DENMARK 04010 WEST DRESDEN 04342 WEST DURHAM 04032

WEST ELLSWORTH 04605 WEST FALMOUTH 04105 WEST FORKS 04985 WEST FRANKLIN 04634 WEST FRYEBURG 04037 WEST GARDINER 04345 WEST GARDINER 04350 WEST GORHAM 04038

WEST GOULDSBORO 04607 WEST GRAY 04039 WEST HARPSWELL 04079

WEST HARRINGTON 04643 WEST HOLLIS 04042 WEST JONESPORT 04649

WEST KENNEBUNK 04094 WEST LEBANON 04027 WEST LEEDS 04263 WEST LEVANT 04456 WEST LOVELL 04051 WEST LUBEC 04652 WEST MILLS 04938 WEST MINOT 04288 WEST MOUNT VERNON 04352 WEST NEWFIELD 04095 WEST OLD TOWN 04468 WEST PARIS 04289 WEST PEMBROKE 04666

WEST PENOBSCOT 04476 WEST PERU 04290 WEST POLAND 04291 WEST PRINCETON 04668 WEST QUODDY HEAD 04652 WEST ROCKPORT 04865 WEST SCARBOROUGH 04074 WEST SEBOOIS 04462 WEST SOUTHPORT 04576

WEST STONINGTON 04681 WEST SULLIVAN 04689 WEST SUMNER 04292 WEST TREMONT 04690 WEST WALDOBORO 04572

WEST WINTERPORT 04496 WESTBROOK 04092 WESTFIELD 04787 WESTMANLAND 04783 WESTON 04424 WESTPOINT 04565

WESTPORT ISLAND 04578 WHITEFIELD 04362 WILLIAMSBURG 04414 WILLIMANTIC 04443 WILTON 04294 WINDEMERE 04988 WINDHAM 04062 WINDHAM 04082

WINDHAM CENTER 04082 WINDSOR 04363 WINGS MILLS 04917 WINN 04495 WINNECOOK 04922 WINSLOW 04901 WINTER HARBOR 04693 WINTER HARBOR NAVAL SECURITY 04693 WINTERPORT 04496 WINTHROP 04364 WISCASSET 04578 WONSQUEAK HARBOR 04613 WOODLAND 04736 WOODLAND 04694 WOODSTOCK 04219 WOODVILLE 04458 WOOLWICH 04579 WORTHLEY POND 04229 WYMAN 04658 WYTOPITLOCK 04497 YARMOUTH 04096 YORK 03909 YORK CENTER 03909 OutOfState Housing status at time of the encounter Who made the request for initial encounter Literally homeless (Street or Shelter) Client Family Residence Family member Friends Residence ED Residential Treatment Facility (Group Home) Community provider Own Residence/Apartment School Police Guardian Other (Not In Drop Down) Please run the data validation macro "Ctrl + M" after you have entered all data into the spreadsheet. The macro, when run, will find most common data issues with the worksheet (Crisis Form). The macro doesn't cover all issues but will find most common errors. After the macro is run, all problem cells will turn color. Please correct any issues in grey cells and rerun the macro. Repeat this process until no grey cells remain. There are two way to run the macro. Select the “View” tab on the top ribbon at far right then select “Marcos” then highlight the macro named “Check_Crisis_Form” and click on “Run” or you can simply hold the Ctrl key down and press M or (Ctrl + M).

Questions? Call lee Richardson at 207-287-4591. ABBOT VILLAGE 04406 ACTON 04001 ADDISON 04606 ALBANY 04267 ALBANY 04231 ALBION 04910 ALFRED 04002 ALLENS MILLS 04938 ALNA 04535 ALTON 04468 AMHERST 04605 AMITY 04465 ANDOVER 04216 ANSON 04911 APPLETON 04862 ARROWSIC 04530 ARUNDEL 04005 ARUNDEL 04046 ASHLAND 04759 ASHLAND 04737 ASHLAND 04732 ASHVILLE 04607 ATHENS 04912 ATKINSON 04410 ATKINSON 04426 ATKINSON CORNER 04426 AUBURN 04210 AUGUSTA 04330 AURORA 04408 AURORA 04605 AVON 04966 AYERS 04666 BAILEY ISLAND 04003 BAILEYVILLE 04694 BALDWIN 04024 BANCROFT 04497 BANCROFT 04424 BANGOR 04401 BAR HARBOR 04609 BAR MILLS 04004 BARING 04694 BARNARD 04414 BASS HARBOR 04653 BATH 04530 BAYSIDE 04605 BAYSIDE 04915 BAYVILLE 04536 BEAR ISLAND 04683 BEDDINGTON 04622 BELFAST 04915 BELGRADE 04917 BELGRADE LAKES 04918 BELMONT 04952 BELMONT 04915 BELMONT CORNER 04915 BENEDICTA 04733 BENTON 04910 BENTON 04936 BENTON FALLS 04901 BENTON STATION 04937 BERNARD 04612 BERWICK 03901 BETHEL 04217 BIDDEFORD 04005 BIDDEFORD POOL 04006 BINGHAM 04920 BIRCH HARBOR 04613 BIRCH ISLAND 04011 BLAINE 04758 BLANCHARD 04406 BLUE HILL 04614 BLUE HILL FALLS 04615 BOLSTERS MILLS 04040 BOOTHBAY 04549 BOOTHBAY 04537 BOOTHBAY HARBOR 04536 BOOTHBAY HARBOR 04570 BOOTHBAY HARBOR 04538 BOWDOIN 04350 BOWDOINHAM 04252 BOWDOINHAM 04008 BOWERBANK 04426 BOYD-LAKE 04463 BRADFORD 04410 BRADFORD CENTER 04410 BRADLEY 04412 BREWER 04412 BREWER LAKE 04474 BRIDGEWATER 04735 BRIDGTON 04009 BRIGHTON 04912 BRIGHTON 04990 BRISTOL 04539 BROOKLIN 04616 BROOKS 04921 BROOKSVILLE 04617 BROOKTON 04413 BROWNFIELD 04010 BROWNVILLE 04414 BRUNSWICK 04053 BRUNSWICK 04011 BRUNSWICK NAVAL AIR STATION 04011 BRYANT POND 04219 BUCKFIELD 04220 BUCKS HARBOR 04618 BUCKSPORT 04416 BUNKERS HARBOR 04613 BURKETTVILLE 04574 BURLINGTON 04417 BURNHAM 04922 BUSTINS ISLAND 04013 BUXTON 04093 BUXTON CENTER 04093 BYRON 04275 CALAIS 04619 CAMBRIDGE 04923 CAMDEN 04843 CAMDEN 04847 CAMP ELLIS 04072 CANAAN 04924 CANTON 04221 CANTON POINT 04221 CAPE COTTAGE 04107 CAPE ELIZABETH 04107 CAPE JELLISON 04981 CAPE NEDDICK 03902 CAPE PORPOISE 04014 CAPE ROSIER 04642 CAPE SPLIT 04606 CAPITOL ISLAND 04538 CARATUNK 04925 CARDVILLE 04418 CARIBOU 04736 CARMEL 04419 CARRABASSET VALLEY 04947 CARRABASSETT 04947 CARROLL 04487 CARSON 04786 CARTHAGE 04224 CARY PLANTATION 04465 CASCO 04015 CASTLE HILL 04732 CASTLE HILL 04757 CASWELL 04750 CEDAR GROVE 04342 CENTER LEBANON 04027 CENTER LOVELL 04016 CENTER MONTVILLE 04941 CENTER VASSALBORO 04989 CENTERVILLE 04623

CENTRAL M E POWER CO 04336 CHAMBERLAIN 04541 CHAPMAN 04757 CHARLESTON 04422 CHARLOTTE 04666 CHEBEAGUE ISLAND 04017 CHELSEA 04345 CHELSEA 04330 CHERRYFIELD 04622 CHESTER 04458 CHESTERVILLE 04352 CHESTERVILLE 04938 CHESTERVILLE 04955 CHESUNCOOK DAM 04441 CHESUNCOOK VILLAGE 04441 CHINA 04358 CHISHOLM 04239 CHRISTMAS COVE 04568 CLARK ISLAND 04859 CLAYTON LAKE 04737 CLAYTON LAKE 04732 CLIFF ISLAND 04019 CLIFTON 04428 CLIFTON CORNERS 04428 CLINTON 04927 COBURN GORE 04936 CODYVILLE 04490 COLBY 04736 COLBY COLLEGE 04901 COLES CORNER 04496 COLUMBIA 04623 COLUMBIA 04643 COLUMBIA FALLS 04623 CONCORD 04979 CONNORS 04736 COOKS CORNER 04011 COOPERS MILLS 04341 COPLIN 04982 COREA 04624 CORINNA 04928 CORINNA CENTER 04928 CORINTH 04427 CORNISH 04020 CORNVILLE 04976 COSTIGAN 04423 COUSINS ISLAND 04096 CRAWFORD 04694 CROUSEVILLE 04786 CRYSTAL 04747 CUMBERLAND 04021 CUMBERLAND CENTER 04021

CUMBERLAND FORESIDE 04110 CUMBERLAND MILLS 04092 CUNDYS HARBOR 04011 CUPSUPTIC 04964 CUSHING 04563 CUTLER 04626 CUTLER NAVAL COMMUNICATIONS 04630 CUTTS ISLAND 03905 CYR PLANTATION 04785 DAIGLE 04743 DALLAS 04970 DAMARISCOTTA 04543 DAMASCUS 04419 DANFORTH 04492 DANFORTH 04424 DANVILLE 04223 DAYTON 04005 DEBLOIS 04622 DEDHAM 04429 DEER ISLE 04627 DENMARK 04022 DENNISTOWN 04945 DENNYSVILLE 04628 DERBY 04463 DETROIT 04929 DEXTER 04930 DICKEY 04774 DIXFIELD 04224 DIXMONT 04932 DIXMONT CENTER 04932 DOLBY 04430 DORMAN 04643 DOUGLAS HILL 04024 DOVER 04426 DOVER-FOXCROFT 04426 DRESDEN 04342 DREW 04497 DRY MILLS 04039 DRYDEN 04225 DUCKTRAP 04849 DURHAM 04032 DURHAM 04252 DURHAM 04069 DURHAM 04210 DYER BROOK 04747 E PLANTATION 04758 EAGLE ISLAND 04683 EAST ANDOVER 04226 EAST AUBURN 04210 EAST BALDWIN 04024 EAST BENTON 04910 EAST BETHEL 04217 EAST BOOTHBAY 04544 EAST BUCKFIELD 04220 EAST CORINTH 04427 EAST DENMARK 04022 EAST DIXFIELD 04227 EAST DIXMONT 04932 EAST DOVER 04426 EAST EDDINGTON 04428 EAST EDGECOMB 04556 EAST EXETER 04427 EAST FRANKLIN 04634 EAST FRIENDSHIP 04547 EAST FRYEBURG 04010 EAST HAMPDEN 04444 EAST HARPSWELL 04011 EAST HIRAM 04041 EAST HOLDEN 04429 EAST HOLDEN 04412 EAST KNOX 04986 EAST LAMOINE 04605 EAST LEBANON 04027 EAST LIMINGTON 04085 EAST LIVERMORE 04228 EAST LOWELL 04433 EAST MACHIAS 04630 EAST MADISON 04976 EAST MILLINOCKET 04430 EAST NEW PORTLAND 04961 EAST NORTHPORT 04915 EAST ORLAND 04431 EAST ORRINGTON 04474 EAST OTISFIELD 04270 EAST PALERMO 04354 EAST PARSONFIELD 04028 EAST PERU 04229 EAST PITTSTON 04345 EAST POLAND 04230 EAST RUMFORD 04276 EAST SEBAGO 04029 EAST STONEHAM 04231 EAST SULLIVAN 04607 EAST SUMNER 04220 EAST SURRY 04605 EAST THORNDIKE 04986 EAST TROY 04987 EAST WATERBORO 04030 EAST WATERFORD 04233 EAST WILTON 04234 EAST WINDHAM 04082 EAST WINN 04455 EAST WINTHROP 04343 EASTBROOK 04634 EASTON 04740 EASTON CENTER 04740 EASTPORT 04631 EATON 04424 EDDINGTON 04428 EDDINGTON 04412 EDGECOMB 04556 EDINBURG 04448 EDMUNDS TOWNSHIP 04628 EGGEMOGGIN 04650 EGYPT 04605 ELIOT 03903 ELLIOTTSVILLE 04464 ELLSWORTH 04605 ELLSWORTH FALLS 04605 EMBDEN 04979 EMBDEN 04958 EMERY MILLS 04031 ENFIELD 04433

ESTABROOK SETTLEMENT 04465 ETNA 04434 ETNA CENTER 04434 EUSTIS 04936 EXETER 04435 EXETER CENTER 04435 EXETER CORNER 04435 EXETER MILLS 04427 EXETER MILLS 04435 FAIRBANKS 04938 FAIRFIELD 04937 FAIRFIELD CENTER 04937 FAIRMOUNT 04742 FALMOUTH 04105 FALMOUTH FORESIDE 04105 FARMINGDALE 04345 FARMINGTON 04938 FAYETTE 04352 FAYETTE 04349 FERRY BEACH 04072 FIVE ISLANDS 04546 FLETCHERS LANDING 04605 FOREST CITY 04413 FORT FAIRFIELD 04742 FORT KENT 04743 FORT KENT VILLAGE 04743 FOXCROFT 04426 FRANKFORT 04438 FRANKLIN 04634 FREEDOM 04941 FREEMAN 04983 FREEPORT 04032 FRENCHBORO 04635 FRIENDSHIP 04547 FRYE 04235 FRYEBURG 04037 GARDINER 04345 GARFIELD 04732 GEORGETOWN 04548 GERRISHVILLE 04693 GERRY 04468 GILEAD 04217 GLEN COVE 04846 GLENBURN 04401 GLENBURN 04449 GLENBURN CENTER 04401 GLENWOOD 04497 GOOSE ROCKS BEACH 04046 GORHAM 04038 GOTTS ISLAND 04653 GOULDSBORO 04607 GRAND FALLS 04417 GRAND ISLE 04746 GRAY 04039 GREAT FALLS 04210 GREAT SPRUCE HEAD ISLAND 04683 GREAT WORKS 04468 GREELEY LANDING 04426 GREEN LAKE 04429 GREENBUSH 04423 GREENE 04236 GREENFIELD 04423 GREENVILLE 04441 GREENVILLE 04485 GREENVILLE JUNCTION 04442 GREENWOOD 04289 GRINDSTONE 04460 GRINDSTONE NECK 04693 GROVEVILLE 04038 GUERETTE 04783 GUILFORD 04443 GUILFORD 04482 HALL QUARRY 04660 HALLDALE 04986 HALLOWELL 04347 HAMLIN 04785 HAMMOND 04730 HAMPDEN 04444 HAMPDEN HIGHLANDS 04444 HANCOCK 04640 HANCOCK POINT 04640 HANOVER 04237 HARBOR ISLANDS 04109 HARBORSIDE 04642 HARMONY 04942 HARPSWELL 04079 HARRINGTON 04643 HARRISON 04040 HARTFORD 04220 HARTFORD 04221 HARTLAND 04943 HAYNESVILLE 04446 HEBRON 04238 HERMON 04401 HERMON 04419 HERMON CENTER 04401 HERON ISLAND 04568 HERSEY 04747 HERSEY 04765 HIGGINS BEACH 04074 HIGHLAND 04961 HIRAM 04041 HOLDEN 04429 HOLLIS 04042 HOLLIS CENTER 04042 HOPE 04847 HOUGHTON 04275 HOULTON 04730 HOWES CORNERS 04969 HOWLAND 04448 HOWLAND CENTER 04448 HOYTTOWN 04654 HUDSON 04449 HUDSON 04450 INDIAN POINT 04660 INDIAN RIVER 04606 INDIAN TOWNSHIP INDIAN RESER 04668 INDUSTRY 04938 ISLAND FALLS 04747 ISLE AU HAUT 04645 ISLE OF SPRINGS 04549 ISLESBORO 04848 JACKMAN 04945 JACKMAN STATION 04945 JACKSON 04921 JACKSONVILLE 04630 JAY 04239 JAY 04262 JEFFERSON 04348 JONESBORO 04648 JONESPORT 04649 KEEGAN 04785 KENDUSKEAG 04456 KENDUSKEAG 04450 KENDUSKEAG 04401 KENNEBAGO LAKE 04970 KENNEBEC 04654 KENNEBUNK 04043 KENNEBUNK BEACH 04043 KENNEBUNKPORT 04046 KENNEBUNKPORT 04014 KENTS HILL 04349 KEZAR FALLS 04047 KINGFIELD 04947 KINGMAN 04451 KINGSBURY 04990 KITTERY 03904 KITTERY POINT 03905 KNOWLES CORNER 04780 KNOX 04921 KNOX 04941 KNOX 04952 KNOX 04986 KNOX CENTER 04986 KOKADJO 04441 L L BEAN CO 04033 LA GRANGE 04453 LAGRANGE 04453 LAKE MOXIE 04985 LAKE VIEW 04463

LAKEVILLE PLANTATION 04487 LAKEWOOD 04976 LAMOINE 04605 LARONE 04937 LARRABEE 04655 LAWRY 04547 LEBANON 04027 LEE 04455 LEEDS 04263 LEVANT 04456 LEWISTON 04240 LEXINGTON 04961 LIBERTY 04949 LILLE 04749 LIMERICK 04048 LIMESTONE 04751 LIMESTONE 04750 LIMINGTON 04049 LINCOLN 04457 LINCOLN CENTER 04458 LINCOLNS MILLS 04928 LINCOLNVILLE 04849 LINCOLNVILLE BEACH 04849 LINCOLNVILLE CENTER 04850 LINNEUS 04730 LISBON 04250 LISBON CENTER 04251 LISBON FALLS 04252 LITCHFIELD 04350 LITTLE DEER ISLE 04650 LITTLE MACHIAS 04626 LITTLETON 04760 LITTLETON 04730 LIVERMORE 04253 LIVERMORE FALLS 04254 LOCKE MILLS 04255 LONG ISLAND 04050 LONG ISLAND 04635 LORING A F B 04751 LORING AFB 04751

LORING AIR FORCE BASE 04751 LOVELL 04051 LOWELL 04433 LOWER DENNYSVILLE 04628 LUBEC 04652 LUCERNE IN MAINE 04429 LUCERNE-IN-MAINE 04429 LUDLOW 04730 LYMAN 04005 LYNCHVILLE 04231 MAC MAHAN 04546 MACHIAS 04686 MACHIAS 04654 MACHIASPORT 04655 MACWAHOC 04451 MADAWASKA 04756 MADAWASKA LAKE 04783 MADISON 04950 MADRID 04966 MAINE MARITIME ACADEMY 04420 MAINSTREAM 04942 MANCHESTER 04351 MANSET 04679 MANSET 04656 MAPLE GROVE 04742 MAPLETON 04757 MAPLEWOOD 04095 MARIAVILLE 04605 MARION TOWNSHIP 04628 MARLBORO 04605 MARS HILL 04758 MARSHFIELD 04654 MARSHVILLE 04643 MARTIN 04547 MARTINSVILLE 04860 MASARDIS 04759 MATINICUS 04851 MATTAWAMKEAG 04459 MAXFIELD 04463 MAXFIELD 04453 MAYFIELD 04990 ME STATE AGENCIES 04333 MECHANIC FALLS 04256 MEDDYBEMPS 04657 MEDFORD 04453 MEDFORD 04463 MEDOMAK 04551 MEDWAY 04460 MERCER 04957 MEREPOINT 04053 MERRILL 04780 MEXICO 04257 MIDDLEDAM 04216 MILBRIDGE 04658 MILFORD 04461 MILL ISLAND 04683 MILLINOCKET 04462 MILLONOCKET CENTER 04462 MILLTOWN 04619 MILO 04463 MINOT 04258 MOLUNKUS 04451 MONARDA 04776 MONHEGAN 04852 MONMOUTH 04259 MONROE 04951 MONROE CENTER 04921 MONSON 04464 MONTICELLO 04760 MONTVILLE 04941 MONTVILLE 04952 MONTVILLE 04986 MOODY 04054 MOODY BEACH 04054 MOOSE RIVER 04945 MOOSEHEAD 04442 MORO 04780 MORRILL 04952 MORRILL 04915 MOSCOW 04920 MOUNT CHASE 04765 MOUNT DESERT 04660 MOUNT VERNON 04352 NAPLES 04055 NASHVILLE 04732 NASKEAG 04616 NAVAL AIR STATION 04011 NEADEAUVILLE 04459 NEW AUBURN 04210 NEW CANADA 04743 NEW GLOUCESTER 04260 NEW HARBOR 04554 NEW MEADOWS 04530 NEW PORTLAND 04954 NEW SHARON 04955 NEW SWEDEN 04762 NEW VINEYARD 04956 NEWAGEN 04552 NEWBURGH 04932 NEWBURGH 04444 NEWBURGH 04419 NEWCASTLE 04553 NEWFIELD 04056 NEWPORT 04953 NEWRY 04261 NOBLEBORO 04555 NORRIDGEWOCK 04957 NORTH AMITY 04465 NORTH ANSON 04958 NORTH AUBURN 04210 NORTH BALDWIN 04024 NORTH BANCROFT 04424 NORTH BANGOR 04401 NORTH BATH 04530 NORTH BERWICK 03906 NORTH BETHEL 04217 NORTH BLUE HILL 04614 NORTH BRADFORD 04410 NORTH BREWER 04412 NORTH BRIDGTON 04057 NORTH BROOKLIN 04661 NORTH BROOKSVILLE 04617 NORTH BUCKFIELD 04220 NORTH CARMEL 04419 NORTH CASTINE 04472 NORTH CHESTERVILLE 04938 NORTH CUTLER 04626 NORTH CUTLER 04630 NORTH DIXMONT 04932 NORTH EAST CARRY 04478 NORTH EDGECOMB 04556 NORTH ELLSWORTH 04605 NORTH FAIRFIELD 04937 NORTH FRYEBURG 04058 NORTH GRAY 04039 NORTH GUILFORD 04443 NORTH HARPSWELL 04079 NORTH HAVEN 04853 NORTH JAY 04262 NORTH LEBANON 04027 NORTH LEEDS 04263 NORTH LIMINGTON 04085 NORTH LIVERMORE 04254 NORTH LOVELL 04231 NORTH LUBEC 04652 NORTH LYNDON 04736 NORTH MONMOUTH 04265 NORTH MONROE 04951 NORTH NEW PORTLAND 04961 NORTH NEWPORT 04928 NORTH ORLAND 04429 NORTH ORRINGTON 04474 NORTH PALERMO 04354 NORTH PARIS 04289 NORTH PARSONFIELD 04047 NORTH PENOBSCOT 04476 NORTH PERRY 04667 NORTH PITTSTON 04345 NORTH POWNAL 04069 NORTH SCARBOROUGH 04074 NORTH SEARSMONT 04915 NORTH SEARSPORT 04974 NORTH SEBAGO 04029 NORTH SEDGWICK 04676 NORTH SHAPLEIGH 04060 NORTH SULLIVAN 04689 NORTH TURNER 04266 NORTH VASSALBORO 04962 NORTH WADE 04786 NORTH WALDOBORO 04572 NORTH WATERBORO 04061 NORTH WATERFORD 04267 NORTH WAYNE 04284 NORTH WHITEFIELD 04353 NORTH WINDHAM 04062 NORTH YARMOUTH 04069 NORTH YARMOUTH 04096 NORTH YARMOUTH 04021 NORTHFIELD 04654 NORTHPORT 04915 NORTHPORT 04849 NORUMBEGA 04617 NORWAY 04268 NOTRE DAME 04749 OAKFIELD 04763 OAKLAND 04963 OCEAN PARK 04063 OCEAN POINT 04544 OCEANVILLE 04681 OGONTZ 04478 OGUNQUIT 03907 OLAMON 04467 OLD ORCHARD BEACH 04064 OLD ORCHARD BEACH 04063 OLD TOWN 04468 ONAWA 04464 OOB 04064 OQUOSSOC 04964 ORIENT 04471 ORLAND 04472 ORNVILLE 04463 ORONO 04473 ORRINGTON 04412 ORRINGTON 04474 ORRINGTON CENTER 04474 ORRS ISLAND 04066 OSBORN 04605 OTIS 04605 OTISFIELD 04040 OWLS HEAD 04854 OXBOW 04764 OXFORD 04270 PACKARDS LANDING 04443 PALERMO 04354 PARIS 04271 PARIS HILL 04271 PARKMAN 04443 PARKMAN 04923 PARSONFIELD 04048 PARSONSFIELD 04028 PASSADUMKEAG 04475 PATTEN 04765 PEAKS ISLAND 04108 PEJEPSCOT 04067 PEMAQUID 04558 PEMAQUID BEACH 04554 PEMAQUID HARBOR 04558 PEMBROKE 04666 PENOBSCOT 04476 PENOBSCOT INDIAN RESERVATION 04468 PERRY 04667 PERU 04272 PETER DANA POINT 04668 PHILLIPS 04966 PHIPPSBURG 04567 PHIPPSBURG 04562 PINE POINT 04074 PITTSFIELD 04967 PITTSTON 04345 PITTSTON FARM 04478 PLANTATION 8 04605 PLEASANT POINT 04667 PLEASANT POND 04925 PLEASANT RIDGE 04920 PLYMOUTH 04969 PLYMOUTH 04932 POLAND 04273 POLAND SPRING 04274 POND COVE 04107 POPHAM BEACH 04562 PORT CLYDE 04855 PORTER 04068 PORTERFIELD 04047 PORTLAND 04106 PORTLAND 04105 PORTLAND 04103 PORTLAND 04107 PORTLAND 04101 PORTLAND 04100 PORTLAND 04102 PORTLAND 04109 PORTLAND 04110 PORTLAND 04108 POWNAL 04069 POWNAL CENTER 04069 PRENTISS 04487 PRESQUE ISLE 04769 PRETTY MARSH 04660 PRINCETON 04668 PROSPECT 04981 PROSPECT 04438 PROSPECT FERRY 04981 PROSPECT HARBOR 04669 PROUTS NECK 04074 PULPIT HARBOR 04853 RANDOLPH 04347 RANDOLPH 04345 RANGELEY 04970 RAYMOND 04071 RAZORVILLE 04574 READFIELD 04355 RED BEACH 04619 REED 04497 RICHMOND 04357 RIPLEY 04930 RIPLEY 04643 RIPOGENUS DAM 04441 ROBBINSTON 04671 ROBINSON 04758 ROCKLAND 04841 ROCKPORT 04856 ROCKWOOD 04478 ROME 04957 ROME 04352 ROME 04963 ROME 04955 ROQUE BLUFFS 04648 ROQUE BLUFFS 04654 ROUND POND 04564 ROXBURY 04275 RUMFORD 04276 RUMFORD CENTER 04278 RUMFORD POINT 04279 SABATTUS 04280 SABBATHDAY LAKE 04274 SACO 04072 SAINT AGATHA 04772 SAINT ALBANS 04971 SAINT DAVID 04773 SAINT FRANCIS 04774 SAINT GEORGE 04857 SALEM 04983 SANDY RIVER 04970 SANFORD 04073 SANGERVILLE 04479 SARGENTVILLE 04673 SCARBOROUGH 04074 SEAL COVE 04674 SEARSMONT 04915 SEARSMONT 04973 SEARSPORT 04974 SEAWALL 04656 SEAWALL 04679 SEBAGO 04029 SEBAGO LAKE 04075 SEBASCO ESTATES 04565 SEBEC 04463 SEBEC CORNERS 04426 SEBEC LAKE 04482 SEBEC LAKE 04443 SEBEC STATION 04426 SEBOOMOOK 04478 SEDGWICK 04676 SHAKER VILLAGE 04274 SHAPLEIGH 04076 SHEEPHEAD ISLAND 04683 SHEEPSCOTT 04578 SHERMAN 04776 SHERMAN MILLS 04776 SHERMAN STA 04777 SHERMAN STATION 04777 SHIN POND 04765 SHIRLEY 04485 SHIRLEY MILLS 04485 SIDNEY 04963 SIDNEY 04330 SILVER RIDGE 04776 SINCLAIR 04779 SKOWHEGAN 04976 SKOWHEGON 04924 SMALL POINT 04567 SMITHVILLE 04680 SMYRNA 04780 SMYRNA CENTER 04780 SMYRNA MILLS 04780 SOLDIER POND 04781 SOLON 04979 SOMERVILLE 04341 SOMERVILLE 04354 SOMERVILLE 04348 SOMESVILLE 04660 SORRENTO 04677 SOUTH ADDISON 04606 SOUTH ANDOVER 04216 SOUTH ARM 04216 SOUTH BANCROFT 04424 SOUTH BERWICK 03908 SOUTH BLUE HILL 04615 SOUTH BREWER 04412 SOUTH BRIDGTON 04009 SOUTH BRISTOL 04568 SOUTH BROOKSVILLE 04617 SOUTH BUXTON 04038 SOUTH CASCO 04077 SOUTH CHINA 04358 SOUTH DEER ISLE 04681 SOUTH DOVER 04426 SOUTH DURHAM 04032 SOUTH ELIOT 03903 SOUTH ETNA 04434 SOUTH EXETER 04928 SOUTH FREEPORT 04078 SOUTH FREEPORT 04013 SOUTH GARDINER 04359 SOUTH GORHAM 04038 SOUTH GOULDSBORO 04678 SOUTH GRAY 04039 SOUTH HARPSWELL 04079 SOUTH HIRAM 04080 SOUTH HOLLIS 04042 SOUTH HOPE 04862 SOUTH LAGRANGE 04453 SOUTH LEBANON 04027 SOUTH LEVANT 04456 SOUTH LEWISTON 04240 SOUTH LIBERTY 04949 SOUTH LIMINGTON 04048 SOUTH LINCOLN 04457 SOUTH LIVERMORE 04254 SOUTH LUBEC 04652 SOUTH MONMOUTH 04259 SOUTH MONTVILLE 04949 SOUTH ORLAND 04472 SOUTH ORRINGTON 04474 SOUTH PARIS 04281 SOUTH PARSONSFIELD 04048 SOUTH PENOBSCOT 04476 SOUTH PORTLAND 04106 SOUTH PRINCETON 04668 SOUTH RANGELEY 04964 SOUTH RUMFORD 04276 SOUTH SANFORD 04073 SOUTH SEBEC 04426 SOUTH SURRY 04684 SOUTH THOMASTON 04858 SOUTH TRESCOTT 04652 SOUTH WALDOBORO 04572 SOUTH WATERFORD 04081 SOUTH WINDHAM 04082 SOUTH WINDSOR 04363 SOUTH WOODVILLE 04458 SOUTHPORT 04576 SOUTHWEST HARBOR 04679 SOUTHWEST HARBOR 04656 SOUTHWEST HARBOR COAST GUARD 04679 SPRAGUEVILLE 04769 SPRINGFIELD 04487 SPRINGVALE 04083 SPRUCE HEAD 04859 SPRUCE POINT 04538 SQUA PAN 04732 SQUIRREL ISLAND 04570 SQUIRREL ISLAND 04538 STANDISH 04084 STARBOARD 04618 STARKS 04911 STEEP FALLS 04085 STETSON 04488 STEUBEN 04680 STOCKHOLM 04783 STOCKTON SPRINGS 04981 STONEHAM 04231 STONINGTON 04645 STONINGTON 04681 STOW 04058 STRATTON 04982 STRONG 04983 SULLIVAN 04634 SULLIVAN 04689 SUMNER 04220 SUMNER 04292 SUNSET 04683 SUNSHINE 04627 SURRY 04684 SURRY 04605 SWANVILLE 04915 SWANVILLE 04438 SWEDEN 04762 SWEDEN 04040 TALMADGE 04492 TEMPLE 04984 TENANTS HARBOR 04860 THE FORKS 04985 THOMASTON 04861 THORNDIKE 04986 THORNDIKE CENTER 04986 TIBBETTSTOWN 04623 TOGUS 04330 TOPSFIELD 04490 TOPSHAM 04086 TREMONT 04653 TRENTON 04605 TREVETT 04571 TROUTDALE 04985 TROY 04987 TROY CENTER 04987 TURNER 04282 TURNER 04283 TURNER CENTER 04283 UNION 04862

UNION MUTUAL LIFE INS 04122

UNION MUTUAL LIFE INS 04123

UNION MUTUAL LIFE INS 04124 UNIONVILLE 04622 UNITY 04988 UNITY COLLEGE 04988 UNIVERSITY OF MAINE 04473 UNIVERSITY OF MAINE 04469 UPPER ABBOT 04406 UPTON 04261 VAN BUREN 04785 VASSALBORO 04989 VEAZIE 04401 VERONA 04416 VIENNA 04360 VINALHAVEN 04863 WADE 04786 WAITE 04424 WAITE 04492 WALDO 04952 WALDO 04921 WALDO 04915 WALDOBORO 04572 WALES 04259 WALES 04280 WALLAGRASS 04781 WALPOLE 04573 WALTHAM 04605 WALTHAM 04634 WARREN 04864 WASHBURN 04786 WASHINGTON 04574 WATERBORO 04087 WATERBORO CENTER 04030 WATERFORD 04088 WATERVILLE 04901 WAVERLY 04967 WAYNE 04284 WEBSTER PLANTATION 04487 WEEKS MILLS 04955 WEEKS MILLS 04361 WELD 04285 WELLINGTON 04990 WELLS 04090 WELLS BEACH 04090 WESLEY 04686 WEST APPLETON 04949 WEST ATHENS 04912 WEST AUBURN 04210 WEST BALDWIN 04091 WEST BATH 04530 WEST BETHEL 04286

WEST BOOTHBAY HARBOR 04575 WEST BOWDOIN 04287 WEST BRIDGTON 04009 WEST BROOKSVILLE 04617 WEST BUXTON 04093 WEST CHARLESTON 04422 WEST CORINTH 04427 WEST CUMBERLAND 04021 WEST DENMARK 04010 WEST DRESDEN 04342 WEST DURHAM 04032 WEST ELLSWORTH 04605 WEST FALMOUTH 04105 WEST FORKS 04985 WEST FRANKLIN 04634 WEST FRYEBURG 04037 WEST GARDINER 04345 WEST GARDINER 04350 WEST GORHAM 04038 WEST GOULDSBORO 04607 WEST GRAY 04039 WEST HARPSWELL 04079 WEST HARRINGTON 04643 WEST HOLLIS 04042 WEST JONESPORT 04649 WEST KENNEBUNK 04094 WEST LEBANON 04027 WEST LEEDS 04263 WEST LEVANT 04456 WEST LOVELL 04051 WEST LUBEC 04652 WEST MILLS 04938 WEST MINOT 04288 WEST MOUNT VERNON 04352 WEST NEWFIELD 04095 WEST OLD TOWN 04468 WEST PARIS 04289 WEST PEMBROKE 04666 WEST PENOBSCOT 04476 WEST PERU 04290 WEST POLAND 04291 WEST PRINCETON 04668 WEST QUODDY HEAD 04652 WEST ROCKPORT 04865 WEST SCARBOROUGH 04074 WEST SEBOOIS 04462 WEST SOUTHPORT 04576 WEST STONINGTON 04681 WEST SULLIVAN 04689 WEST SUMNER 04292 WEST TREMONT 04690 WEST WALDOBORO 04572 WEST WINTERPORT 04496 WESTBROOK 04092 WESTFIELD 04787 WESTMANLAND 04783 WESTON 04424 WESTPOINT 04565 WESTPORT ISLAND 04578 WHITEFIELD 04362 WILLIAMSBURG 04414 WILLIMANTIC 04443 WILTON 04294 WINDEMERE 04988 WINDHAM 04062 WINDHAM 04082 WINDHAM CENTER 04082 WINDSOR 04363 WINGS MILLS 04917 WINN 04495 WINNECOOK 04922 WINSLOW 04901 WINTER HARBOR 04693 WINTER HARBOR NAVAL SECURITY 04693 WINTERPORT 04496 WINTHROP 04364 WISCASSET 04578 WONSQUEAK HARBOR 04613 WOODLAND 04736 WOODLAND 04694 WOODSTOCK 04219 WOODVILLE 04458 WOOLWICH 04579 WORTHLEY POND 04229 WYMAN 04658 WYTOPITLOCK 04497 YARMOUTH 04096 YORK 03909 YORK CENTER 03909 OutOfState Initial AMHC 2014 January Follow up Community Health and Counseling 2015 February Maine Behavioral Healthcare - Biddeford March Crisis & Counseling Centers, Inc. April Evergreen Behavioral Services May

Oxford County Mental Health Services June Maine Behavioral Healthcare - Rockland July Sweetser August The Opportunity Alliance September Tri-County Mental Health Services October November December

Any first nameAny last name ABBOT VILLAGE 04406 ACTON 04001 ADDISON 04606 ALBANY 04267 ALBANY 04231

ALBION 04910 ALFRED 04002 ALLENS MILLS 04938 ALNA 04535 ALTON 04468 AMHERST 04605 AMITY 04465 ANDOVER 04216 ANSON 04911 APPLETON 04862 ARROWSIC 04530 ARUNDEL 04005 ARUNDEL 04046 ASHLAND 04759 ASHLAND 04737 ASHLAND 04732 ASHVILLE 04607 ATHENS 04912 ATKINSON 04410 ATKINSON 04426 ATKINSON CORNER 04426 AUBURN 04210 AUGUSTA 04330 AURORA 04408 AURORA 04605 AVON 04966 AYERS 04666 BAILEY ISLAND 04003 BAILEYVILLE 04694 BALDWIN 04024 BANCROFT 04497 BANCROFT 04424 BANGOR 04401 BAR HARBOR 04609 BAR MILLS 04004 BARING 04694 BARNARD 04414 BASS HARBOR 04653 BATH 04530 BAYSIDE 04605 BAYSIDE 04915 BAYVILLE 04536 BEAR ISLAND 04683 BEDDINGTON 04622 BELFAST 04915 BELGRADE 04917 BELGRADE LAKES 04918 BELMONT 04952 BELMONT 04915 BELMONT CORNER 04915 BENEDICTA 04733 BENTON 04910 BENTON 04936 BENTON FALLS 04901 BENTON STATION 04937 BERNARD 04612 BERWICK 03901 BETHEL 04217 BIDDEFORD 04005 BIDDEFORD POOL 04006 BINGHAM 04920 BIRCH HARBOR 04613 BIRCH ISLAND 04011 BLAINE 04758 BLANCHARD 04406 BLUE HILL 04614 BLUE HILL FALLS 04615 BOLSTERS MILLS 04040 BOOTHBAY 04549 BOOTHBAY 04537 BOOTHBAY HARBOR 04536 BOOTHBAY HARBOR 04570 BOOTHBAY HARBOR 04538 BOWDOIN 04350 BOWDOINHAM 04252 BOWDOINHAM 04008 BOWERBANK 04426 BOYD-LAKE 04463 BRADFORD 04410 BRADFORD CENTER 04410 BRADLEY 04412 BREWER 04412 BREWER LAKE 04474 BRIDGEWATER 04735 BRIDGTON 04009 BRIGHTON 04912 BRIGHTON 04990 BRISTOL 04539 BROOKLIN 04616 BROOKS 04921 BROOKSVILLE 04617 BROOKTON 04413 BROWNFIELD 04010 BROWNVILLE 04414 BRUNSWICK 04053 BRUNSWICK 04011 BRUNSWICK NAVAL AIR STATION 04011 BRYANT POND 04219 BUCKFIELD 04220 BUCKS HARBOR 04618 BUCKSPORT 04416 BUNKERS HARBOR 04613 BURKETTVILLE 04574 BURLINGTON 04417 BURNHAM 04922 BUSTINS ISLAND 04013 BUXTON 04093 BUXTON CENTER 04093 BYRON 04275 CALAIS 04619 CAMBRIDGE 04923 CAMDEN 04843 CAMDEN 04847 CAMP ELLIS 04072 CANAAN 04924 CANTON 04221 CANTON POINT 04221 CAPE COTTAGE 04107 CAPE ELIZABETH 04107 CAPE JELLISON 04981 CAPE NEDDICK 03902 CAPE PORPOISE 04014 CAPE ROSIER 04642 CAPE SPLIT 04606 CAPITOL ISLAND 04538 CARATUNK 04925 CARDVILLE 04418 CARIBOU 04736 CARMEL 04419

CARRABASSET VALLEY 04947 CARRABASSETT 04947 CARROLL 04487 CARSON 04786 CARTHAGE 04224 CARY PLANTATION 04465 CASCO 04015 CASTLE HILL 04732 CASTLE HILL 04757 CASWELL 04750 CEDAR GROVE 04342 CENTER LEBANON 04027 CENTER LOVELL 04016 CENTER MONTVILLE 04941

CENTER VASSALBORO 04989 CENTERVILLE 04623 CENTRAL M E POWER CO 04336 CHAMBERLAIN 04541 CHAPMAN 04757 CHARLESTON 04422 CHARLOTTE 04666 CHEBEAGUE ISLAND 04017 CHELSEA 04345 CHELSEA 04330 CHERRYFIELD 04622 CHESTER 04458 CHESTERVILLE 04352 CHESTERVILLE 04938 CHESTERVILLE 04955 CHESUNCOOK DAM 04441

CHESUNCOOK VILLAGE 04441 CHINA 04358 CHISHOLM 04239 CHRISTMAS COVE 04568 CLARK ISLAND 04859 CLAYTON LAKE 04737 CLAYTON LAKE 04732 CLIFF ISLAND 04019 CLIFTON 04428 CLIFTON CORNERS 04428 CLINTON 04927 COBURN GORE 04936 CODYVILLE 04490 COLBY 04736 COLBY COLLEGE 04901 COLES CORNER 04496 COLUMBIA 04623 COLUMBIA 04643 COLUMBIA FALLS 04623 CONCORD 04979 CONNORS 04736 COOKS CORNER 04011 COOPERS MILLS 04341 COPLIN 04982 COREA 04624 CORINNA 04928 CORINNA CENTER 04928 CORINTH 04427 CORNISH 04020 CORNVILLE 04976 COSTIGAN 04423 COUSINS ISLAND 04096 CRAWFORD 04694 CROUSEVILLE 04786 CRYSTAL 04747 CUMBERLAND 04021

CUMBERLAND CENTER 04021 CUMBERLAND FORESIDE 04110 CUMBERLAND MILLS 04092 CUNDYS HARBOR 04011 CUPSUPTIC 04964 CUSHING 04563 CUTLER 04626 CUTLER NAVAL COMMUNICATIONS 04630 CUTTS ISLAND 03905 CYR PLANTATION 04785 DAIGLE 04743 DALLAS 04970 DAMARISCOTTA 04543 DAMASCUS 04419 DANFORTH 04492 DANFORTH 04424 DANVILLE 04223 DAYTON 04005 DEBLOIS 04622 DEDHAM 04429 DEER ISLE 04627 DENMARK 04022 DENNISTOWN 04945 DENNYSVILLE 04628 DERBY 04463 DETROIT 04929 DEXTER 04930 DICKEY 04774 DIXFIELD 04224 DIXMONT 04932 DIXMONT CENTER 04932 DOLBY 04430 DORMAN 04643 DOUGLAS HILL 04024 DOVER 04426 DOVER-FOXCROFT 04426 DRESDEN 04342 DREW 04497 DRY MILLS 04039 DRYDEN 04225 DUCKTRAP 04849 DURHAM 04032 DURHAM 04252 DURHAM 04069 DURHAM 04210 DYER BROOK 04747 E PLANTATION 04758 EAGLE ISLAND 04683 EAST ANDOVER 04226 EAST AUBURN 04210 EAST BALDWIN 04024 EAST BENTON 04910 EAST BETHEL 04217 EAST BOOTHBAY 04544 EAST BUCKFIELD 04220 EAST CORINTH 04427 EAST DENMARK 04022 EAST DIXFIELD 04227 EAST DIXMONT 04932 EAST DOVER 04426 EAST EDDINGTON 04428 EAST EDGECOMB 04556 EAST EXETER 04427 EAST FRANKLIN 04634 EAST FRIENDSHIP 04547 EAST FRYEBURG 04010 EAST HAMPDEN 04444 EAST HARPSWELL 04011 EAST HIRAM 04041 EAST HOLDEN 04429 EAST HOLDEN 04412 EAST KNOX 04986 EAST LAMOINE 04605 EAST LEBANON 04027 EAST LIMINGTON 04085 EAST LIVERMORE 04228 EAST LOWELL 04433 EAST MACHIAS 04630 EAST MADISON 04976 EAST MILLINOCKET 04430 EAST NEW PORTLAND 04961 EAST NORTHPORT 04915 EAST ORLAND 04431 EAST ORRINGTON 04474 EAST OTISFIELD 04270 EAST PALERMO 04354 EAST PARSONFIELD 04028 EAST PERU 04229 EAST PITTSTON 04345 EAST POLAND 04230 EAST RUMFORD 04276 EAST SEBAGO 04029 EAST STONEHAM 04231 EAST SULLIVAN 04607 EAST SUMNER 04220 EAST SURRY 04605 EAST THORNDIKE 04986 EAST TROY 04987 EAST WATERBORO 04030 EAST WATERFORD 04233 EAST WILTON 04234 EAST WINDHAM 04082 EAST WINN 04455 EAST WINTHROP 04343 EASTBROOK 04634 EASTON 04740 EASTON CENTER 04740 EASTPORT 04631 EATON 04424 EDDINGTON 04428 EDDINGTON 04412 EDGECOMB 04556 EDINBURG 04448 EDMUNDS TOWNSHIP 04628 EGGEMOGGIN 04650 EGYPT 04605 ELIOT 03903 ELLIOTTSVILLE 04464 ELLSWORTH 04605 ELLSWORTH FALLS 04605 EMBDEN 04979 EMBDEN 04958 EMERY MILLS 04031 ENFIELD 04433 ESTABROOK SETTLEMENT 04465 ETNA 04434 ETNA CENTER 04434 EUSTIS 04936 EXETER 04435 EXETER CENTER 04435 EXETER CORNER 04435 EXETER MILLS 04427 EXETER MILLS 04435 FAIRBANKS 04938 FAIRFIELD 04937 FAIRFIELD CENTER 04937 FAIRMOUNT 04742 FALMOUTH 04105 FALMOUTH FORESIDE 04105 FARMINGDALE 04345 FARMINGTON 04938 FAYETTE 04352 FAYETTE 04349 FERRY BEACH 04072 FIVE ISLANDS 04546 FLETCHERS LANDING 04605 FOREST CITY 04413 FORT FAIRFIELD 04742 FORT KENT 04743 FORT KENT VILLAGE 04743 FOXCROFT 04426 FRANKFORT 04438 FRANKLIN 04634 FREEDOM 04941 FREEMAN 04983 FREEPORT 04032 FRENCHBORO 04635 FRIENDSHIP 04547 FRYE 04235 FRYEBURG 04037 GARDINER 04345 GARFIELD 04732 GEORGETOWN 04548 GERRISHVILLE 04693 GERRY 04468 GILEAD 04217 GLEN COVE 04846 GLENBURN 04401 GLENBURN 04449 GLENBURN CENTER 04401 GLENWOOD 04497

GOOSE ROCKS BEACH 04046 GORHAM 04038 GOTTS ISLAND 04653 GOULDSBORO 04607 GRAND FALLS 04417 GRAND ISLE 04746 GRAY 04039 GREAT FALLS 04210 GREAT SPRUCE HEAD ISLAND 04683 GREAT WORKS 04468 GREELEY LANDING 04426 GREEN LAKE 04429 GREENBUSH 04423 GREENE 04236 GREENFIELD 04423 GREENVILLE 04441 GREENVILLE 04485

GREENVILLE JUNCTION 04442 GREENWOOD 04289 GRINDSTONE 04460 GRINDSTONE NECK 04693 GROVEVILLE 04038 GUERETTE 04783 GUILFORD 04443 GUILFORD 04482 HALL QUARRY 04660 HALLDALE 04986 HALLOWELL 04347 HAMLIN 04785 HAMMOND 04730 HAMPDEN 04444

HAMPDEN HIGHLANDS 04444 HANCOCK 04640 HANCOCK POINT 04640 HANOVER 04237 HARBOR ISLANDS 04109 HARBORSIDE 04642 HARMONY 04942 HARPSWELL 04079 HARRINGTON 04643 HARRISON 04040 HARTFORD 04220 HARTFORD 04221 HARTLAND 04943 HAYNESVILLE 04446 HEBRON 04238 HERMON 04401 HERMON 04419 HERMON CENTER 04401 HERON ISLAND 04568 HERSEY 04747 HERSEY 04765 HIGGINS BEACH 04074 HIGHLAND 04961 HIRAM 04041 HOLDEN 04429 HOLLIS 04042 HOLLIS CENTER 04042 HOPE 04847 HOUGHTON 04275 HOULTON 04730 HOWES CORNERS 04969 HOWLAND 04448 HOWLAND CENTER 04448 HOYTTOWN 04654 HUDSON 04449 HUDSON 04450 INDIAN POINT 04660 INDIAN RIVER 04606 INDIAN TOWNSHIP INDIAN RESER 04668 INDUSTRY 04938 ISLAND FALLS 04747 ISLE AU HAUT 04645 ISLE OF SPRINGS 04549 ISLESBORO 04848 JACKMAN 04945 JACKMAN STATION 04945 JACKSON 04921 JACKSONVILLE 04630 JAY 04239 JAY 04262 JEFFERSON 04348 JONESBORO 04648 JONESPORT 04649 KEEGAN 04785 KENDUSKEAG 04456 KENDUSKEAG 04450 KENDUSKEAG 04401 KENNEBAGO LAKE 04970 KENNEBEC 04654 KENNEBUNK 04043 KENNEBUNK BEACH 04043 KENNEBUNKPORT 04046 KENNEBUNKPORT 04014 KENTS HILL 04349 KEZAR FALLS 04047 KINGFIELD 04947 KINGMAN 04451 KINGSBURY 04990 KITTERY 03904 KITTERY POINT 03905 KNOWLES CORNER 04780 KNOX 04921 KNOX 04941 KNOX 04952 KNOX 04986 KNOX CENTER 04986 KOKADJO 04441 L L BEAN CO 04033 LA GRANGE 04453 LAGRANGE 04453 LAKE MOXIE 04985 LAKE VIEW 04463 LAKEVILLE PLANTATION 04487 LAKEWOOD 04976 LAMOINE 04605 LARONE 04937 LARRABEE 04655 LAWRY 04547 LEBANON 04027 LEE 04455 LEEDS 04263 LEVANT 04456 LEWISTON 04240 LEXINGTON 04961 LIBERTY 04949 LILLE 04749 LIMERICK 04048 LIMESTONE 04751 LIMESTONE 04750 LIMINGTON 04049 LINCOLN 04457 LINCOLN CENTER 04458 LINCOLNS MILLS 04928 LINCOLNVILLE 04849

LINCOLNVILLE BEACH 04849

LINCOLNVILLE CENTER 04850 LINNEUS 04730 LISBON 04250 LISBON CENTER 04251 LISBON FALLS 04252 LITCHFIELD 04350 LITTLE DEER ISLE 04650 LITTLE MACHIAS 04626 LITTLETON 04760 LITTLETON 04730 LIVERMORE 04253 LIVERMORE FALLS 04254 LOCKE MILLS 04255 LONG ISLAND 04050 LONG ISLAND 04635 LORING A F B 04751 LORING AFB 04751 LORING AIR FORCE BASE 04751 LOVELL 04051 LOWELL 04433 LOWER DENNYSVILLE 04628 LUBEC 04652 LUCERNE IN MAINE 04429 LUCERNE-IN-MAINE 04429 LUDLOW 04730 LYMAN 04005 LYNCHVILLE 04231 MAC MAHAN 04546 MACHIAS 04686 MACHIAS 04654 MACHIASPORT 04655 MACWAHOC 04451 MADAWASKA 04756 MADAWASKA LAKE 04783 MADISON 04950 MADRID 04966 MAINE MARITIME ACADEMY 04420 MAINSTREAM 04942 MANCHESTER 04351 MANSET 04679 MANSET 04656 MAPLE GROVE 04742 MAPLETON 04757 MAPLEWOOD 04095 MARIAVILLE 04605 MARION TOWNSHIP 04628 MARLBORO 04605 MARS HILL 04758 MARSHFIELD 04654 MARSHVILLE 04643 MARTIN 04547 MARTINSVILLE 04860 MASARDIS 04759 MATINICUS 04851 MATTAWAMKEAG 04459 MAXFIELD 04463 MAXFIELD 04453 MAYFIELD 04990 ME STATE AGENCIES 04333 MECHANIC FALLS 04256 MEDDYBEMPS 04657 MEDFORD 04453 MEDFORD 04463 MEDOMAK 04551 MEDWAY 04460 MERCER 04957 MEREPOINT 04053 MERRILL 04780 MEXICO 04257 MIDDLEDAM 04216 MILBRIDGE 04658 MILFORD 04461 MILL ISLAND 04683 MILLINOCKET 04462

MILLONOCKET CENTER 04462 MILLTOWN 04619 MILO 04463 MINOT 04258 MOLUNKUS 04451 MONARDA 04776 MONHEGAN 04852 MONMOUTH 04259 MONROE 04951 MONROE CENTER 04921 MONSON 04464 MONTICELLO 04760 MONTVILLE 04941 MONTVILLE 04952 MONTVILLE 04986 MOODY 04054 MOODY BEACH 04054 MOOSE RIVER 04945 MOOSEHEAD 04442 MORO 04780 MORRILL 04952 MORRILL 04915 MOSCOW 04920 MOUNT CHASE 04765 MOUNT DESERT 04660 MOUNT VERNON 04352 NAPLES 04055 NASHVILLE 04732 NASKEAG 04616 NAVAL AIR STATION 04011 NEADEAUVILLE 04459 NEW AUBURN 04210 NEW CANADA 04743 NEW GLOUCESTER 04260 NEW HARBOR 04554 NEW MEADOWS 04530 NEW PORTLAND 04954 NEW SHARON 04955 NEW SWEDEN 04762 NEW VINEYARD 04956 NEWAGEN 04552 NEWBURGH 04932 NEWBURGH 04444 NEWBURGH 04419 NEWCASTLE 04553 NEWFIELD 04056 NEWPORT 04953 NEWRY 04261 NOBLEBORO 04555 NORRIDGEWOCK 04957 NORTH AMITY 04465 NORTH ANSON 04958 NORTH AUBURN 04210 NORTH BALDWIN 04024 NORTH BANCROFT 04424 NORTH BANGOR 04401 NORTH BATH 04530 NORTH BERWICK 03906 NORTH BETHEL 04217 NORTH BLUE HILL 04614 NORTH BRADFORD 04410 NORTH BREWER 04412 NORTH BRIDGTON 04057 NORTH BROOKLIN 04661 NORTH BROOKSVILLE 04617 NORTH BUCKFIELD 04220 NORTH CARMEL 04419 NORTH CASTINE 04472

NORTH CHESTERVILLE 04938 NORTH CUTLER 04626 NORTH CUTLER 04630 NORTH DIXMONT 04932 NORTH EAST CARRY 04478 NORTH EDGECOMB 04556 NORTH ELLSWORTH 04605 NORTH FAIRFIELD 04937 NORTH FRYEBURG 04058 NORTH GRAY 04039 NORTH GUILFORD 04443 NORTH HARPSWELL 04079 NORTH HAVEN 04853 NORTH JAY 04262 NORTH LEBANON 04027 NORTH LEEDS 04263 NORTH LIMINGTON 04085 NORTH LIVERMORE 04254 NORTH LOVELL 04231 NORTH LUBEC 04652 NORTH LYNDON 04736 NORTH MONMOUTH 04265 NORTH MONROE 04951

NORTH NEW PORTLAND 04961 NORTH NEWPORT 04928 NORTH ORLAND 04429 NORTH ORRINGTON 04474 NORTH PALERMO 04354 NORTH PARIS 04289 NORTH PARSONFIELD 04047 NORTH PENOBSCOT 04476 NORTH PERRY 04667 NORTH PITTSTON 04345 NORTH POWNAL 04069

NORTH SCARBOROUGH 04074 NORTH SEARSMONT 04915 NORTH SEARSPORT 04974 NORTH SEBAGO 04029 NORTH SEDGWICK 04676 NORTH SHAPLEIGH 04060 NORTH SULLIVAN 04689 NORTH TURNER 04266 NORTH VASSALBORO 04962 NORTH WADE 04786 NORTH WALDOBORO 04572 NORTH WATERBORO 04061 NORTH WATERFORD 04267 NORTH WAYNE 04284 NORTH WHITEFIELD 04353 NORTH WINDHAM 04062 NORTH YARMOUTH 04069 NORTH YARMOUTH 04096 NORTH YARMOUTH 04021 NORTHFIELD 04654 NORTHPORT 04915 NORTHPORT 04849 NORUMBEGA 04617 NORWAY 04268 NOTRE DAME 04749 OAKFIELD 04763 OAKLAND 04963 OCEAN PARK 04063 OCEAN POINT 04544 OCEANVILLE 04681 OGONTZ 04478 OGUNQUIT 03907 OLAMON 04467

OLD ORCHARD BEACH 04064

OLD ORCHARD BEACH 04063 OLD TOWN 04468 ONAWA 04464 OOB 04064 OQUOSSOC 04964 ORIENT 04471 ORLAND 04472 ORNVILLE 04463 ORONO 04473 ORRINGTON 04412 ORRINGTON 04474 ORRINGTON CENTER 04474 ORRS ISLAND 04066 OSBORN 04605 OTIS 04605 OTISFIELD 04040 OWLS HEAD 04854 OXBOW 04764 OXFORD 04270 PACKARDS LANDING 04443 PALERMO 04354 PARIS 04271 PARIS HILL 04271 PARKMAN 04443 PARKMAN 04923 PARSONFIELD 04048 PARSONSFIELD 04028 PASSADUMKEAG 04475 PATTEN 04765 PEAKS ISLAND 04108 PEJEPSCOT 04067 PEMAQUID 04558 PEMAQUID BEACH 04554 PEMAQUID HARBOR 04558 PEMBROKE 04666 PENOBSCOT 04476 PENOBSCOT INDIAN RESERVATION 04468 PERRY 04667 PERU 04272 PETER DANA POINT 04668 PHILLIPS 04966 PHIPPSBURG 04567 PHIPPSBURG 04562 PINE POINT 04074 PITTSFIELD 04967 PITTSTON 04345 PITTSTON FARM 04478 PLANTATION 8 04605 PLEASANT POINT 04667 PLEASANT POND 04925 PLEASANT RIDGE 04920 PLYMOUTH 04969 PLYMOUTH 04932 POLAND 04273 POLAND SPRING 04274 POND COVE 04107 POPHAM BEACH 04562 PORT CLYDE 04855 PORTER 04068 PORTERFIELD 04047 PORTLAND 04106 PORTLAND 04105 PORTLAND 04103 PORTLAND 04107 PORTLAND 04101 PORTLAND 04100 PORTLAND 04102 PORTLAND 04109 PORTLAND 04110 PORTLAND 04108 POWNAL 04069 POWNAL CENTER 04069 PRENTISS 04487 PRESQUE ISLE 04769 PRETTY MARSH 04660 PRINCETON 04668 PROSPECT 04981 PROSPECT 04438 PROSPECT FERRY 04981 PROSPECT HARBOR 04669 PROUTS NECK 04074 PULPIT HARBOR 04853 RANDOLPH 04347 RANDOLPH 04345 RANGELEY 04970 RAYMOND 04071 RAZORVILLE 04574 READFIELD 04355 RED BEACH 04619 REED 04497 RICHMOND 04357 RIPLEY 04930 RIPLEY 04643 RIPOGENUS DAM 04441 ROBBINSTON 04671 ROBINSON 04758 ROCKLAND 04841 ROCKPORT 04856 ROCKWOOD 04478 ROME 04957 ROME 04352 ROME 04963 ROME 04955 ROQUE BLUFFS 04648 ROQUE BLUFFS 04654 ROUND POND 04564 ROXBURY 04275 RUMFORD 04276 RUMFORD CENTER 04278 RUMFORD POINT 04279 SABATTUS 04280 SABBATHDAY LAKE 04274 SACO 04072 SAINT AGATHA 04772 SAINT ALBANS 04971 SAINT DAVID 04773 SAINT FRANCIS 04774 SAINT GEORGE 04857 SALEM 04983 SANDY RIVER 04970 SANFORD 04073 SANGERVILLE 04479 SARGENTVILLE 04673 SCARBOROUGH 04074 SEAL COVE 04674 SEARSMONT 04915 SEARSMONT 04973 SEARSPORT 04974 SEAWALL 04656 SEAWALL 04679 SEBAGO 04029 SEBAGO LAKE 04075 SEBASCO ESTATES 04565 SEBEC 04463 SEBEC CORNERS 04426 SEBEC LAKE 04482 SEBEC LAKE 04443 SEBEC STATION 04426 SEBOOMOOK 04478 SEDGWICK 04676 SHAKER VILLAGE 04274 SHAPLEIGH 04076 SHEEPHEAD ISLAND 04683 SHEEPSCOTT 04578 SHERMAN 04776 SHERMAN MILLS 04776 SHERMAN STA 04777 SHERMAN STATION 04777 SHIN POND 04765 SHIRLEY 04485 SHIRLEY MILLS 04485 SIDNEY 04963 SIDNEY 04330 SILVER RIDGE 04776 SINCLAIR 04779 SKOWHEGAN 04976 SKOWHEGON 04924 SMALL POINT 04567 SMITHVILLE 04680 SMYRNA 04780 SMYRNA CENTER 04780 SMYRNA MILLS 04780 SOLDIER POND 04781 SOLON 04979 SOMERVILLE 04341 SOMERVILLE 04354 SOMERVILLE 04348 SOMESVILLE 04660 SORRENTO 04677 SOUTH ADDISON 04606 SOUTH ANDOVER 04216 SOUTH ARM 04216 SOUTH BANCROFT 04424 SOUTH BERWICK 03908 SOUTH BLUE HILL 04615 SOUTH BREWER 04412 SOUTH BRIDGTON 04009 SOUTH BRISTOL 04568 SOUTH BROOKSVILLE 04617 SOUTH BUXTON 04038 SOUTH CASCO 04077 SOUTH CHINA 04358 SOUTH DEER ISLE 04681 SOUTH DOVER 04426 SOUTH DURHAM 04032 SOUTH ELIOT 03903 SOUTH ETNA 04434 SOUTH EXETER 04928 SOUTH FREEPORT 04078 SOUTH FREEPORT 04013 SOUTH GARDINER 04359 SOUTH GORHAM 04038 SOUTH GOULDSBORO 04678 SOUTH GRAY 04039 SOUTH HARPSWELL 04079 SOUTH HIRAM 04080 SOUTH HOLLIS 04042 SOUTH HOPE 04862 SOUTH LAGRANGE 04453 SOUTH LEBANON 04027 SOUTH LEVANT 04456 SOUTH LEWISTON 04240 SOUTH LIBERTY 04949 SOUTH LIMINGTON 04048 SOUTH LINCOLN 04457 SOUTH LIVERMORE 04254 SOUTH LUBEC 04652 SOUTH MONMOUTH 04259 SOUTH MONTVILLE 04949 SOUTH ORLAND 04472 SOUTH ORRINGTON 04474 SOUTH PARIS 04281

SOUTH PARSONSFIELD 04048 SOUTH PENOBSCOT 04476 SOUTH PORTLAND 04106 SOUTH PRINCETON 04668 SOUTH RANGELEY 04964 SOUTH RUMFORD 04276 SOUTH SANFORD 04073 SOUTH SEBEC 04426 SOUTH SURRY 04684 SOUTH THOMASTON 04858 SOUTH TRESCOTT 04652 SOUTH WALDOBORO 04572 SOUTH WATERFORD 04081 SOUTH WINDHAM 04082 SOUTH WINDSOR 04363 SOUTH WOODVILLE 04458 SOUTHPORT 04576 SOUTHWEST HARBOR 04679 SOUTHWEST HARBOR 04656 SOUTHWEST HARBOR COAST GUARD 04679 SPRAGUEVILLE 04769 SPRINGFIELD 04487 SPRINGVALE 04083 SPRUCE HEAD 04859 SPRUCE POINT 04538 SQUA PAN 04732 SQUIRREL ISLAND 04570 SQUIRREL ISLAND 04538 STANDISH 04084 STARBOARD 04618 STARKS 04911 STEEP FALLS 04085 STETSON 04488 STEUBEN 04680 STOCKHOLM 04783 STOCKTON SPRINGS 04981 STONEHAM 04231 STONINGTON 04645 STONINGTON 04681 STOW 04058 STRATTON 04982 STRONG 04983 SULLIVAN 04634 SULLIVAN 04689 SUMNER 04220 SUMNER 04292 SUNSET 04683 SUNSHINE 04627 SURRY 04684 SURRY 04605 SWANVILLE 04915 SWANVILLE 04438 SWEDEN 04762 SWEDEN 04040 TALMADGE 04492 TEMPLE 04984 TENANTS HARBOR 04860 THE FORKS 04985 THOMASTON 04861 THORNDIKE 04986 THORNDIKE CENTER 04986 TIBBETTSTOWN 04623 TOGUS 04330 TOPSFIELD 04490 TOPSHAM 04086 TREMONT 04653 TRENTON 04605 TREVETT 04571 TROUTDALE 04985 TROY 04987 TROY CENTER 04987 TURNER 04282 TURNER 04283 TURNER CENTER 04283 UNION 04862

UNION MUTUAL LIFE INS 04122

UNION MUTUAL LIFE INS 04123

UNION MUTUAL LIFE INS 04124 UNIONVILLE 04622 UNITY 04988 UNITY COLLEGE 04988

UNIVERSITY OF MAINE 04473

UNIVERSITY OF MAINE 04469 UPPER ABBOT 04406 UPTON 04261 VAN BUREN 04785 VASSALBORO 04989 VEAZIE 04401 VERONA 04416 VIENNA 04360 VINALHAVEN 04863 WADE 04786 WAITE 04424 WAITE 04492 WALDO 04952 WALDO 04921 WALDO 04915 WALDOBORO 04572 WALES 04259 WALES 04280 WALLAGRASS 04781 WALPOLE 04573 WALTHAM 04605 WALTHAM 04634 WARREN 04864 WASHBURN 04786 WASHINGTON 04574 WATERBORO 04087 WATERBORO CENTER 04030 WATERFORD 04088 WATERVILLE 04901 WAVERLY 04967 WAYNE 04284

WEBSTER PLANTATION 04487 WEEKS MILLS 04955 WEEKS MILLS 04361 WELD 04285 WELLINGTON 04990 WELLS 04090 WELLS BEACH 04090 WESLEY 04686 WEST APPLETON 04949 WEST ATHENS 04912 WEST AUBURN 04210 WEST BALDWIN 04091 WEST BATH 04530 WEST BETHEL 04286 WEST BOOTHBAY HARBOR 04575 WEST BOWDOIN 04287 WEST BRIDGTON 04009 WEST BROOKSVILLE 04617 WEST BUXTON 04093 WEST CHARLESTON 04422 WEST CORINTH 04427 WEST CUMBERLAND 04021 WEST DENMARK 04010 WEST DRESDEN 04342 WEST DURHAM 04032 WEST ELLSWORTH 04605 WEST FALMOUTH 04105 WEST FORKS 04985 WEST FRANKLIN 04634 WEST FRYEBURG 04037 WEST GARDINER 04345 WEST GARDINER 04350 WEST GORHAM 04038 WEST GOULDSBORO 04607 WEST GRAY 04039 WEST HARPSWELL 04079 WEST HARRINGTON 04643 WEST HOLLIS 04042 WEST JONESPORT 04649 WEST KENNEBUNK 04094 WEST LEBANON 04027 WEST LEEDS 04263 WEST LEVANT 04456 WEST LOVELL 04051 WEST LUBEC 04652 WEST MILLS 04938 WEST MINOT 04288

WEST MOUNT VERNON 04352 WEST NEWFIELD 04095 WEST OLD TOWN 04468 WEST PARIS 04289 WEST PEMBROKE 04666 WEST PENOBSCOT 04476 WEST PERU 04290 WEST POLAND 04291 WEST PRINCETON 04668 WEST QUODDY HEAD 04652 WEST ROCKPORT 04865 WEST SCARBOROUGH 04074 WEST SEBOOIS 04462 WEST SOUTHPORT 04576 WEST STONINGTON 04681 WEST SULLIVAN 04689 WEST SUMNER 04292 WEST TREMONT 04690 WEST WALDOBORO 04572 WEST WINTERPORT 04496 WESTBROOK 04092 WESTFIELD 04787 WESTMANLAND 04783 WESTON 04424 WESTPOINT 04565 WESTPORT ISLAND 04578 WHITEFIELD 04362 WILLIAMSBURG 04414 WILLIMANTIC 04443 WILTON 04294 WINDEMERE 04988 WINDHAM 04062 WINDHAM 04082 WINDHAM CENTER 04082 WINDSOR 04363 WINGS MILLS 04917 WINN 04495 WINNECOOK 04922 WINSLOW 04901 WINTER HARBOR 04693 WINTER HARBOR NAVAL SECURITY 04693 WINTERPORT 04496 WINTHROP 04364 WISCASSET 04578

WONSQUEAK HARBOR 04613 WOODLAND 04736 WOODLAND 04694 WOODSTOCK 04219 WOODVILLE 04458 WOOLWICH 04579 WORTHLEY POND 04229 WYMAN 04658 WYTOPITLOCK 04497 YARMOUTH 04096 YORK 03909 YORK CENTER 03909 OutOfState Any Medicaid Id. Has to be 9 characters and end with an A or T. MaineCare Private Insurance Uninsured Medicare

Any Date Of Birth. Must be a date and Must be a date and between 1900 and between 01/01/2014 Any SSN. Must have 9 numbers 2015. Male and 06/30/2015. Female

Literally homeless (Street or Shelter) Client Yes Family Residence Family member No Friends Residence ED Residential Treatment Facility (Group Home) Community provider Own Residence/Apartment School

Police

Guardian Other (Not In Drop Down)

Primary Residence (Home)

Family/Relative/Other Residence Other Community Setting (Work, School, Police Dept, Public Place) SNF, Nursing Home, Boarding Home Residential Program (Congregate Community Residence, Apartment Program)

Homeless Shelter

Provider Office Crisis Office Emergency Department Other Hospital Location Incarcerated (Local Jail, State Prison, Juvenile Correction Center)

Depression Yes Yes Yes Yes Anxiety No No No No Behavioral Issues--youth NA NA Suicidal Ideation Suicidal Act

Psychosis

Homicidal Ideation Homicidal Act Self-Injury/Assaultive Behavior Substance Abuse Medical Attention needed Mental Health Symptom Decompensating Grief and Loss Domestic Abuse Acute Stress No medical Based Change in Mental Status Sexual Assault Overdose Inability to care for self

Any whole number Any whole number Any whole number Yes between 0 and 500 between 1 and 500 between 1 and 500 Yes no No NA NA

Crisis Stabilization with no referrals for Mental health/substance abuse follow-up.

Crisis Stabilization with referral to new provider for Mental Health/Substance Abuse follow-up. Crisis Stabilization with referral back to current provider for Mental Health/Substance Abuse follow-up. Admission to Crisis Stabilization unit. Inpatient Hospitalization - Medical.

Voluntary Psychiatric Hospitalization.

Involuntary Psychiatric Hospitalization. Admission to Detox Unit. Instructions for completing Crisis Spread Sheet: Crisis Form V2_2014.xls

Column A: Type of Encounte

Data Accepted: − Initial − Follow up

Description: An Initial Encounter is a first contact with a client for a new Crisis. All Initial Encounters

Example: − A crisis worker first meets with a client who is in crisis and is placed into substance abuse

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column B: Agency Name

Data Accepted: − Only the agency names from the drop-down menu and spelled exactly like they are in the

Example: − See drop-down menu in spread sheet.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column C: Report Year

Data Accepted: − Only Report Years from the drop-down menu and spelled exactly like they are in the drop

Example: − See drop-down menu in spread sheet.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column D: Report Month

Data Accepted: − Only Report Months from the drop-down menu and spelled exactly like they are in the dro

Example: − See drop-down menu in spread sheet.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column E: First Name

Data Accepted: − For MaineCare and Medicare clients their complete first name. − For Uninsured and Private Insurance clients ONLY. Enter either the first letter of their

Example: − Uninsured client named Bill OnTheHill. Either use B for first name or Bill for first name

Example: − Medicaid client named Bill OnTheHill. Enter Bill for the first name.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column F: Last Name

Data Accepted: − MaineCare and Medicare clients - their complete last name. − Uninsured and Private Insurance clients ONLY. Enter either the first letter of their la

Example: − Uninsured client named Bill OnTheHill. Either use O for last name or OnTheHill for la

Example: − MaineCare client named Bill OnTheHill. Enter OnTheHill for the last name.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column G: Town Zip

Data Accepted: − Only Towns and Zips from the drop-down menu and spelled exactly like they are in the d

Example: − See drop-down menu in spread sheet.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: If there is no town list where the client was seen pick the closest town on the list.

Note: This field is required.

Column H: Medicaid Id

Data Accepted: − MaineCare or Medicaid number which is the same.

Quality Data Check: Required for MaineCare clients . Check for missing entries and spelling errors

Note: If you have a client that you are billing MaineCare or Medicaid for crisis services you must enter

Note: This field is required.

Column I: Payment Source

Data Accepted: − MaineCare − Private Insurance − Uninsured − Medicare Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

Column J: SSN

Description: A SSN is 9 characters long and is numerical (000000000) no letters. Enter the client’s so Quality Data Check: Social Security numbers are required for Uninsured clients.

Column K: DOB

Data Accepted: − Date of Birth as a date.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required. One missing DOB means the sheet is rejected because many counts of cli

Column L: Gender

Data Accepted: − Male − Female Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: One missing gender means the sheet is rejected because many counts of clients depend on the gen

Note: This field is required.

Column M: Date Of Encounter

Data Accepted: − Date of encounter as a date.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: This field is required.

*** NEW Column N: Housing status at time of the encounter

Data Accepted: -Literally homeless (Street or Shelter) -Family Residence -Friends Residence -Residential Treatment Facility (Group Home) -Own Residence/Apartment

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

***NEW Column O: Who made the request for initial encounter-Client

Data Accepted: -Client -Family member -ED -Community provider -School -Police -Guardian - Other (Not In Drop Down)

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

***NEW Column P: Did the assessment from this encounter indicate the client would benefit from substanc

Data Accepted: -Yes -No

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Column Q: Site Of Face To Face Encounter

Data Accepted: − Primary Residence (Home) − Family/Relative/Other Residence − Other Community Setting (Work, School, Police Dept, Public Place) − SNF, Nursing Home, Boarding Home − Residential Program (Congregate Community Residence, Apartment Program) − Homeless Shelter − Provider Office − Crisis Office − Emergency Department − Other Hospital Location − Incarcerated (Local Jail, State Prison, Juvenile Correction Center)

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One missing from this column m

Note: This field is required.

Column R: Crisis Assessment Criteria

Description: What did the crisis client present as the reason for the crisis?

Data Accepted (exclude comments in red): − Depression − Anxiety − Behavioral Issues--youth − Suicidal Ideation (suicide thoughts) − Suicidal Act (suicide attempt) − Psychosis − Homicidal Ideation (homicidal thoughts) − Homicidal Act (homicidal act) − Self-Injury/Assaultive Behavior (not suicide/homicide) − Substance Abuse − Medical Attention needed − Mental Health Symptom Decompensating − Grief and Loss − Domestic Abuse − Acute Stress − No medical Based Change in Mental Status − Sexual Assault − Inability to care for self − Overdose (not suicide attempt) − ******Deliberate Self harm ****** deleted

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One entry missing from this colum Note: This field is required.

Column S: If this client is under 18 do they have a MENTAL RETARDATION/ AU

Data Accepted: − Yes − No − NA

Description: If the client is an adult, select NA.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One entry missing from this colu Note: This field is required.

Column T: Is this Crisis Encounter the result of an on going support for a previous

Data Accepted: − Yes − No

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One entry missing from this colu

Note: This field is required.

Column U: Does this client have a wellness plan, crisis plan, ISP or advanced direct

Data Accepted: − Yes − No

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One entry missing from this colu

Note: This field is required. Column V: Does this client have a Community Support Worker (CI, CRS, ICM, AC

Data Accepted: − Yes − No

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report.

Note: This field is required.

Column W: If the client had a Community Support Worker, was that worker notifi

Data Accepted: − Yes − No − NA

Description: If the client didn’t have a Community Support worker, select NA.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report. One entry missing from this colu

Note: This field is required.

Column X: Time in MINUTES between determination of need for initial face to fac

Description: Required for Initial Face To Face Encounters only . Enter time in Minutes as a whole

Data accepted: − Minutes as a whole number.

Examples: − 31 − 60 − 241

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Sums of the data in this field are used in the summary report. Note: This field is required.

Column Y: Time in HOURS from initial Face to Face Encounter to Disposition of C

Description: Initial Face To Face Encounters Only. Required for Initial Encounters. Enter time in Ho

Data accepted: − Hours as a whole number.

Examples: − 1 − 4 − 123

Quality Data Check: Check for missing entries and spelling errors simply alphabetizing the spreadshe

Note: Sums of the data in this field are used in the summary report.

Column Z: Time in HOURS for Non Initial Face (Follow up) to Face Encounter

Description: Follow Up Face To Face Encounters Only. Enter Time in Hours as a whole number. If t

Data accepted: Hours as a whole number.

Examples: − 1 − 4 − 123

Quality Data Check: Check for missing entries and spelling errors simply alphabetizing the spreadshe

Note: Sums of the data in this field are used in the summary report.

Column AA: If this client is under 18 are they in State Custody?

Description: If the client is an Adult select NA. Data Accepted: − Yes − No − NA.

Description: If the client didn’t have a Community Support worker, select NA.

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report.

Note: This field is required.

Column AB: Crisis Resolution (Mutually Exclusive and Exhaustive)

Description: For initial encounters only. Use your clinical experience and select a Crisis Resolution th

Data Accepted: − Crisis Stabilization with no referrals for mental health/substance abuse follow-up. − Crisis Stabilization with referral to new provider for Mental Health/Substance Abuse follo − Crisis Stabilization with referral back to current provider for Mental Health/Substance Ab − Admission to Crisis Stabilization unit. − Inpatient Hospitalization - Medical. − Voluntary Psychiatric Hospitalization. − Involuntary Psychiatric Hospitalization. − Admission to Detox Unit.

Quality Data Check: Check for missing entries and spelling errors simply alphabetizing the spreadshe

Note: Counts of the data in this field are used in the summary report. One entry missing from this colu

DELETED -Column Z: Critical Incident Report Submitted?

Data Accepted: − Yes − No

Quality Data Check: Required . Required means no missing entries. Check for missing entries and sp

Note: Counts of the data in this field are used in the summary report.

Note: This field is required. s will have a corresponding Crisis Resolution (Mutually Exclusive and Exhaustive) selection. Foll

e treatment facility (Initial). Then the crisis councilor meets with the client at the treatment facilit

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

drop-down menu will be accepted.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual check

p-down menu. pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual check

op-down menu.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

r first name or their full first name.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

ast name or their full name. ast name.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

drop-down menu.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

simply alphabetizing the spreadsheet by this column, and doing a simple visual check of the colu

r this number. If MaineCare is selected as Payment Source there must be a MaineCare number o pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

cial security if known; if not leave blank.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

ients depend on the DOB.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec nder.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec ce abuse treatment.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

means the sheet is rejected because many counts of clients depend on this item.

Crisis Assessment Criteria

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

mn means the sheet is rejected because many counts of clients depend on this item. UTISM/PERVASIVE/Developmental DISORDER.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

umn means the sheet is rejected because many counts of clients depend on this item.

Is this Crisis Encounter the result of an on going support for a previous crisi

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

umn means the sheet is rejected because many counts of clients depend on this item.

tive plan previously developed that was used for this encounter.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

umn means the sheet is rejected because many counts of clients depend on this item. CT, TCM)

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

ied of the crisis.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

umn means the sheet is rejected because many counts of clients depend on this item.

ce contact or when client was ready and able to be seen, to initial face to face contact

number. Round down minutes. If a Follow Up encounter leave blank.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec risis.

ours as a whole number. Round down hours except for initial encounters less than 1 hour then en

eet by this column and doing a simple visual check of the column. Null values will come to the to

the encounter was less than an hour, enter 1 hour. Round down hours otherwise. If an Initial enco

eet by this column and doing a simple visual check of the column. Null values will come to the to pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec

hat is the closest to one of these choices. Select for Initial Encounters only. Leave blank if a Fo

ow-up. buse follow-up.

eet by this column and doing a simple visual check of the column. Null values will come to the to

umn means the sheet is rejected because many counts of clients depend on this item.

pelling errors simply alphabetizing the spreadsheet by this column and doing a simple visual chec low-up encounters are follow-up contact(s) with a crisis client after there has been a Crisis Resolu

ty to see how the treatment is progressing (Follow-up).

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

k of the column. Null values will come to the top. Misspellings will usually be at the beginning o k of the column. Null values will come to the top. Misspellings will usually be at the beginning o

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

umn. Null values will come to the top. Misspellings will usually be at the beginning of the column

or how else would you get paid? ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning o

ck of the column. Select as the client self-Identifies. Null values will come to the top. Misspelling

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

is resolution/stabilization.

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning nter 1 hour. If a Follow Up encounter leave blank.

op. Misspellings will usually be at the beginning of the column or at the end. There must be an en

ounter leave blank.

op. Make sure there is at least 1 hour for each Follow Up encounter. ck of the column. Null values will come to the top. Misspellings will usually be at the beginning

ollow Up encounter.

op. Misspellings will usually be at the beginning of the column or at the end.

ck of the column. Null values will come to the top. Misspellings will usually be at the beginning ution to the Initial Encounter. Follow-up encounters will not have a Crisis Resolution (Mutually E

of the column or at the end.

of the column or at the end. of the column or at the end.

of the column or at the end.

of the column or at the end. of the column or at the end.

of the column or at the end.

n or at the end. of the column or at the end.

of the column or at the end.

gs will usually be at the beginning of the column or at the end.

of the column or at the end. of the column or at the end.

of the column or at the end.

of the column or at the end. As the assessment indicates not clients perspective. of the column or at the end.

of the column or at the end. of the column or at the end.

of the column or at the end.

of the column or at the end. of the column or at the end.

of the column or at the end.

of the column or at the end. ntry of at least 1 hour for every initial encounter. Please check this because your sheet will be reje of the column or at the end.

of the column or at the end. Exclusive and Exhaustive) selection

ected if not.