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Downloadable Forms

Adobe PDF Format

Click the appropriate link to download and print the document you need


  • INSTRUCTIONS FOR FILLING OUT THE ELIGIBILITY FORM
  • MEDICAL ASSISTANCE TRANSPORTATION program ELIGIBILITY FORM
  • Authorization for Release of Health Care Information
  • MATP No-Show Policy
  • Mileage Reimbursement Form
  • CONSUMER COMMENT/COMPLAINT REPORT
  • Verification of Diability or Special needs

Haga clic en el enlace correspondiente para descargar e imprimir el documento que necesita


  • INSTRUCCIONES PARA COMPLETAR EL FORMULARIO DE ELEGIBILIDAD
  • ASISTENCIA MEDICA FORMA DE ELEGIBILIDAD programa de transporte
  • Autorización para la Divulgación de Información de la Atención
  • MATP por no presentarse
  • AFIRMACIÓN DE INFORMACIÓN forma

Microsoft Word Format

Click the appropriate link to download and print the document you need


  • INSTRUCTIONS FOR FILLING OUT THE ELIGIBILITY FORM
  • MEDICAL ASSISTANCE TRANSPORTATION program ELIGIBILITY FORM
  • Authorization for Release of Health Care Information
  • MATP No-Show Policy
  • Mileage Reimbursement Form
  • CONSUMER COMMENT/COMPLAINT REPORT

Haga clic en el enlace correspondiente para descargar e imprimir el documento que necesita


  • INSTRUCCIONES PARA COMPLETAR EL FORMULARIO DE ELEGIBILIDAD
  • ASISTENCIA MEDICA FORMA DE ELEGIBILIDAD programa de transporte
  • Autorización para la Divulgación de Información de la Atención
  • MATP por no presentarse
  • AFIRMACIÓN DE INFORMACIÓN forma

Building Strong Communities

The Center for Community Building is a Nonprofit Organization Offering Transportation Brokerage in Harrisburg, Pennsylvania.

Our goal is to provide you with dependable transportation assistance no matter where your're headed

Financial Support

  • CCB funding comes from Dauphin County, United Way of the Capital Region, private donations and fees-for-service.

Office Hours

  • Monday - Friday
  • 8:00am - 4:30pm

Contact Us

3525 N 6th Street

Harrisburg, PA 17110-1474

Local: 717-232-9880

Fax: 717-232-9883

www.centerforcommunitybuilding.org

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Hours of Operation: 8:00 am- 4:30 pm, Monday-Friday