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A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Provide a password for the new account in both fields.
This information will NOT be public to other users.
Organization Street Address
- Select a value -
District of Columbia
- None -
Type of Organization
Healthcare provider, Clinic, Hospital
Other direct service organization
Is your organization a non-profit?
Are you an assister (Navigator/CACs)?
Type of Assister
Direct federal grantee
Direct state grantee
Other Assister Type
Please tell us a little more about your organization’s involvement in the enrollment process.
Which populations do you help enroll?
Immigrants and Mixed Status Families
People with disabilities
Native Hawaiians or other Pacific Islanders
Native Americans or Alaska Natives
What organization and/or person referred you to In the Loop?
Terms and Conditions of Use
Terms & Conditions
to abide by the
Terms & Conditions of Use
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.