Treatment Providers

This area of the website is for the use of treatment provider agencies contracted with Dauphin SCA. If you have any questions about these documents, please contact us at 717-635-2254. 

Block Data Grant Forms for CER Reporting Requirements

***Fill out a separate form for each level of care provided to Dauphin County residents***

Levels 3.7 WM and 4 WM

Levels 3.5 and 3.7

Levels 1, 2.1, and 2.5

IDU and Other Drug Protocol Form

RASE Data Form

Level 3.1

Methadone (Lvl 1), Suboxone, and Vivitrol Forms

Other Forms