NE/IA 211 Data Request Form Date Requested * Name * Name First First Last Last Organization * Position * Email * Phone * Due Date (Minimum 7 business days) * *UWM cannot guarantee that we can complete your data request by the need by date, but we will do our best to fulfill your request. Purpose of Request (Please describe your request including audience and intended use) * Timeframe for data * Last Fiscal Year Last Calendar Year OtherOther *Please note, NE211 began covering the entire state of Iowa in July 2023. Iowa data is not available from before July 2023.* Location You Are Requesting Data For State * Zipcode County(ies) City(ies) Types of Count (you can select multiple) * Need (all) Unmet Needs (with reasons) Met Needs Caller Calls ADRC (NE Only) Unite NE (NE Only) HMG (NE Only) Agreement * I understand and agree that all data provided to me will be used for its intended purpose and will not be manipulated or used out of context. I agree to acknowledge United Way of the Midlands 211 as the source and give appropriate credit when creating any product sourced by the data provided. If the data you are requesting is already available through the public NE/IA 211 dashboard we will direct you to the dashboard. Captcha Submit If you are human, leave this field blank.