Keep Maine Healthy
Certificate of Compliance for Maine Visitors

Name

First Last

More than a place, Maine is how we live. Keep it Maine is about all of us working together, staying the course, remaining true to our spirit as a state. So far, Maine is keeping its COVID-19 infection rates and hospitalizations relatively low because we’re keeping to the values that tie us together. Let’s keep it up. Let’s keep it Maine.

To help “Keep Maine Healthy,” guests of Maine commercial lodging establishments, campgrounds, seasonal rentals, or short-term rentals are required to complete this certificate prior to their stay. This initiative promotes the safety of Maine residents and visitors coming to enjoy all Maine has to offer. To that end, the State of Maine asks you to review and attest to the following:

I am a resident of the State of Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut*

Yes
No

Compliance Questions

I certify that I have not experienced or displayed any of the following COVID-19 symptoms in the last 24 hours:*

Yes

Fever or chills
Sore throat, cough, shortness of breath, or other respiratory symptoms
Muscle aches, severe fatigue, or chills
Changes in taste or smell

I certify that I have not had close contact with anyone over the last 14 days who is confirmed to have COVID-19.*

Yes

I certify that ONE of the following is true (PLEASE CHECK ONE):*

I have received a negative antigen or molecular test result for COVID-19 on a specimen taken no longer than 72 hours prior to my arrival, consistent with Maine CDC guidance,
I am getting a test taken in Maine and will remain in quarantine until I get a negative antigen or molecular test result
I will quarantine for 10 days upon arrival in Maine or for the duration of the stay,
I have completed a 10-day quarantine in Maine prior to my stay,
I had a positive PCR test taken within the last 3 months and already completed my isolation.
I have taken the final dose of one of the FDA approved COVID-19 vaccines more than 14 days before my arrival in Maine.

What date was your test taken on?*

We recommend getting tested at the Portland Jetport or at one of Maine's Swab and Send Sites.

Please enter where you completed your 10-day quarantine within the State of Maine.*

While in Maine, I agree to do my part to Keep Maine Healthy by following recommended safety measures in order to protect myself and others.*

Yes

I also certify that all persons in my care who are under the age of 18, or who are dependent on my care, meet the criteria described in items 1 and 2.*

Yes
There is no one under the age of 18 in my care.

Please provide the ages of such persons in your care.

I have read and understand this entire Certificate of Compliance and agree the certifications made above are accurate.*

Yes

Contact Information

PLEASE PROVIDE THE NAME LISTED ON YOUR RESERVATION BELOW.

WE ARE NOT ABLE TO MATCH THE NAME TO YOUR RESERVATION IF YOU ARE USING DIFFERENT NAMES. THIS WILL RESULT IN YOU NOT RECEIVING A KEY FOR YOUR STAY.

First Name*

Last Name*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Enter Email Confirm Email

Additional Persons from the Same Household (Optional)

Arrival Information

Estimated Arrival Time*

To help us best prepare for your arrival into Maine, please provide us your estimated arrival time into Portland.

:

Common Questions About Arrival Times

May I arrive earlier than 4 pm?

Your estimated arrival time is not a guaranteed time your residence will be available, but helps our team plan cleaning and maintenance tasks.

When will my residence be ready?

Residences are released to guests as soon as cleaning and maintenance tasks are complete. Your residence will be available no later than 4 pm on your arrival date.

When will I receive my FLEXIPASS keycode?

When your residence is ready on your arrival day, you will receive an email with your FLEXIPASS key code. The standard check-in time is 4pm.

Can I store luggage?

There is no space on property to store luggage.

Should I contact you and ask about arrival times?

Please refrain from contacting us about an early arrival. Our team is focused on preparing for your stay.

What if I have other questions?

Please refer to your welcome email and the FAQ section of this website for other detailed information

*

I understand my estimated arrival time is not a guarantee of when your residence will be available for arrival. Residences are available by no later than 4 pm. When your residence is available for arrival, an email will be sent to you with your FLEXIPASS code.

I understand

Privacy

The information obtained in this document will be kept on file with 121 MIDDLE an urban inn for 30 days. After 30 days, this information will be removed and deleted from our website servers. This information may be shared with State of Maine officials, upon request.

Phone

This field is for validation purposes and should be left unchanged.

Keep Maine Healthy
Certificate of Compliance for Maine Visitors

Compliance Questions

Contact Information

Arrival Information

Privacy

Get in touch with us

Contact Us

Portland
Maine

(207) 709-1217

contact@121middle.com

121 Middle Street

EXTENDED
rentals

Keep Maine HealthyCertificate of Compliance for Maine Visitors

Compliance Questions

Contact Information

Arrival Information

Privacy

Get in touch with us

Contact Us

Portland Maine

(207) 709-1217

contact@121middle.com

121 Middle Street

EXTENDED rentals

Keep Maine Healthy
Certificate of Compliance for Maine Visitors

Portland
Maine

EXTENDED
rentals