Service Provider Application

211 Answers, Please!
Health and Human Social Services Information and Referral Program

District of Columbia Department of Human Services
Contact 211 Answers, Please! by Email

Agency / Parent Organiztion Information

Fields marked with an asterisk (*) are required.  If the information is not for public view, enter the word “Confidential” in the associated field.

Name of Agency / Organization
Phone Numbers
Internet Information
General Information
Key Contacts for 211 Answers, Please!
(To be used for correspondence to update the database)
Please indicate whether or not you give permission for your agency and programs may be included on the 211 Answers, Please! website, in directories, or any articles we may publish.
This question is for testing whether you are a human visitor and to prevent automated spam submissions.