Download intake application below, print, and fill out information.  The packet asks for information regarding the individual who is in need of help.  Once information is filled out, please email or fax information.  


​Fax: 717-383-4162

Step 3

Physical Form

Step 2


ROFM Men's Center of Hope

Information on What to Bring to Program

Offering HOPE-HELP to men and families struggling with addiction.

Step 1

After packet is completed and sent, call us in order to move forward with the intake process.  When you call, the intake coordinator will ask several questions.  In order to accept the student, we will need to talk to the student personally.  If you have a loved one who does not want help but needs it, we offer ARISE interventions.

After a student has been accepted, the student is required to get a physical. Please download and print physical form below.

Other Intake Resources


After physical form is completed, the student can enter the program.  When a student is transported to the program, the family or friends will be given the opportunity to ask any questions they may have.  After the family leaves, the intake coordinator will go over documents with the student.  Below you will see other documents.

Below is information on what is necessary to bring to the program and things that are not allowed.


1st Phase Resources

2nd Phase Resources

The intake process is 3 easy steps.  Please follow directions below.  In event of an individual needs help ASAP, some of the process may be skipped.  Call us with any questions you may have.  Go to get in touch page to get contact information.