The Child Placing Agencies application must be completed and contain all the documents listed below. The staff reviews all documents and forms and determine if the requirements are met for survey and ultimately licensure. Please follow the instructions for each and include all forms in the application in hard copy format.
Printable Forms: Print the form, fill it out, sign it, and include it with the application package.
Specific instructions are provided within each form below.
Application Package Documents
- License Application Form [PDF]
- Required Attachments [PDF] (updated 04/18/19)
- Clean Hands Certification [PDF]
- Disclosure of Ownership [PDF]
Contact Phone:
(877) 672-2174
Contact Fax:
(202) 727-8471
Contact TTY:
711
Office Hours:
Monday to Friday 8:15 am to 4:45 pm
Service Location:
Health, Department of
GIS Address:
899 North Capitol Street, NE
City:
Washington
State:
DC
Zip:
20002