How to Apply (2)

If you are currently in an impatient treatment facility and need to apply for a Public Defender you will need to read the information below and provide the following:

1.  Completed Public Defender Application

2.  Signed Financial Affidavit

3.  Copy of criminal charges and proof of income you may be receiving.

4.  Letter from the treatment facility outlining the details of your treatment, i.e. date of your admittance and the length of your stay, if known.

5.  Name and phone number of your counselor at the facility (on application).

6.  If the treatment facility/counselor needs a release of information form signed in order for our office to speak to them on your behalf, please include a signed copy of their release form with your application.

7.  We conduct phone interviews on Friday afternoons between the hours of 1:00 P.M. — 4:00 P.M.  Please indicate what time during those hours you would be available at the number that you have provided so one of our staff members can contact you for a phone interview (we will accommodate your time request as best as possible).

8.  All of the above information can be returned to our office by fax: 717-771-4759.

9.  If at any point you are moved to a new treatment facility or you have changed treatment facilities you must notify our office immediately. On the same note, if you are released from treatment you must immediately contact our office with your home addess and contact phone number.

10. Please keep in mind, until you are interviewed by one of our staff members, our office does NOT represent you.

***Please note: the above information only applies to individuals who are currently in inpatient treatment and should be completed and returned by the individual or by the counselor at the treatment facility in which they are located***