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Parent to Parent of Pennsylvania 6340 Flank Drive Harrisburg PA 17112 Fax- 717-657-5895 Email fpatrick parenttoparent. 1-888-727-2706 AUTHORIZATION TO RELEASE INFORMATION FORM EARLY INTERVENTION INFANT TODDLER AND PRESCHOOL PROGRAMS/ Direct Referrals Date REFERRING AGENCY /COUNTY Provide Service Coordination for the Infant Toddler Program REFERRING PERSON / CONTACT NUMBER Parent/ Caregiver Address City Primary Number Best time to call Email Address If you would like one of our Parent to...

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