211: Resource Database External Request Intake Form

Submission Date*

Date

Request Type (pick only one):*

Off Cycle iCarol Program Record Updates (Description: Agency provides a list of resources that need to be contacted so information can be updated in the database or procesess executed beyond standard operating procedures or scope of work as stated in existing agreement with the requesting organization.)Report Requests (Description: Requests for specialized reports not currently available externally)Quality Control (Description: Reviewing specific program records for errors, indicating what needs to be made, making coorections to iCarol records. This can include taxonomy, specific fields, or more general information as well as updates to websites. Please specify which websites, if any, need to be checked in the "Additional Details" below.)Adding New Programs to Database (Description: Requests that a specific list of resources be added to the database beyond standard operating procedures or scope of work as stated in existing agreement with requesting organization.)Accessing 211 Raw Data (Description: An agency has an interest in 211 qualitative or quantitative data beyond what is publicly available on the UWCM website.)Other

Off Cycle iCarol Program Record Updates – provide number of resources to be updated

Report Requests – provide timeframe of report period, areas of interest (i.e., food, housing, etc), region of interest (zip code(s), county)

Quality Control – provide number of resources that need to be updated, if there is an error on a website, specify website address

Adding New Programs to Database – provide number of programs to be added

Accessing 211 Raw Data - provide timeframe of data requested, areas of interest (i.e., food, housing, etc.), region of interest (zip code(s), county)

If this is related to a specific initiative, please name the initiative

Name of Requestor*

Requestor’s Agency*

Requestor’s Email*

Requestor's Phone Number

(By providing your phone number and submitting this form, you consent to be contacted by SMS text message or phone call. Message and data rates may apply. Reply STOP to opt out of SMS messages.)

Are you making this request on behalf of another organization? If yes, name of organization originating request.

Timeframe for completion of request*

1 week2 weeks1 month> 1 month

Any additional information?