HOH of Franklin County RESIDENT APPLICATION Logo
  • House of Hope of Franklin County Inc.

    Phone: 717-414-7666 Fax: 717-496-8780

    230 E. Queen Street, Chambersburg, PA 17201

    Email: lhateheroin@comcast.net

  • HOUSE OF HOPE of Franklin County -APPLICATION FOR RESIDENCY

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  • DRUG USAGE

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  • CURRENT LEGAL STATUS

  • If currently incarcerated, expected release date:

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  • FINANCIAL STATUS

  • MEDICAL/PHYSICAL STATUS

  • MENTAL HEALTH STATUS

  • List any Medical Treatments/Counseling (include where and dates)

  • MEDICATIONS

  • PRIOR TREATMENT PROGRAMS

  • DEPENDENT CHILDREN

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  • House of Hope Phone: 717-414-7666 Fax: 717-496-8780 230 E. Queen Street, Chambersburg, PA 17201 Email: lhateheroin@comcast.net

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  • A journey of a 1000 miles begins with the first step to a better life.

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