If you are adding a new agency and service, please select "New Agency and Service". If you are adding only a service (because your agency is already listed in the 211 database), please select "Service Only".



New Agency and Service = Not in 211 Database
New Service = Agency is listed in the 211 Database Currently
AGENCY INFORMATION





This could be a 501c3 Tax Exempt letter, business license, etc.





Brief one-two sentence description of what the agency does.



i.e. 8:00am-5:00pm, Monday-Thursday
LOCATION INFORMATION






If the address is confidential, it will not be shared with the general public.



Suite, Room #, Building A, etc








SERVICE INFORMATION



aka; also known as

A program description is a short detailed summary of the organization’s prime nature and activities. Use search terms such as food, housing, and additional information about your services that would be helpful for clients and for 211 agents to identify appropriate referrals.

Eligibility can be stated in terms of requirements or exclusions.

If no age limit, will default to 0

If no age limit, will default to 105

What area do clients have to live in to receive services? Examples include: Statewide, San Diego County, City of San Diego, Downtown San Diego, 92101

Days when a client can call, walk-in or go online for information/services

Time when a client can call, walk-in or go online for information/services

Time and day for the specific service. For example, intake hours are 8:00 am-5:00 pm, Monday-Friday, but service hours are 6:00 pm, Tuesday







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Ctr + Left Click to Select Multiple Options


Ctr + Left Click to Select Multiple Options

Ctr + Left Click to Select Multiple Options






















Update Contact






SIGNATURE

BY ENTERING MY INFORMATION BELOW, I VERIFY THAT ALL OF THE INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I HAVE READ AND UNDERSTOOD 2-1-1 SAN DIEGO’S INCLUSION/EXCLUSION POLICY LINKED ON THIS WEBPAGE AND WILL SUBMIT ALL FORMS OF PROOF OF LICENSURE AS REQUIRED BY REGULATING AGENCIES. I ALSO AM AWARE THAT APPLICATIONS WILL BE PROCESSED WITHIN 30 DAYS.


I UNDERSTAND THAT IN ORDER TO KEEP 2-1-1 SAN DIEGO’S DATABASE ACCURATE AND UP TO DATE, I AM REQUIRED TO INFORM 2-1-1 SAN DIEGO OF CHANGES TO THE AGENCY’S OPERATIONS WITHIN 30 DAYS.


I UNDERSTAND THAT 2-1-1 SAN DIEGO CONDUCTS AN ANNUAL SURVEY TO VERIFY CURRENT INFORMATION AND THAT IN ORDER TO REMAIN WITHIN THE DATABASE I MUST COMPLY WITH UPDATING THE INFORMATION UPON REQUEST. FAILURE TO COMPLY WITH THESE REQUIREMENTS MAY RESULT IN THE DEACTIVATION OF MY AGENCY OR AGENCIES SERVICES WITHIN THE 2-1-1 DATABASE.