Information Collection

Authorization for Medical, Dental, and Mental Health Care (Form P-2)

IC 242788 under ICR 202012-0970-010 · OMB 0970-0554.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0554 can be found here:

Documents and Forms

Document Name Document Type
Form P-2 Authorization for Medical, Dental, and Mental Health Care (Form P-2) Form
P-2 Authorization for Medical, Dental, and Mental Health Car TAB D - Authorization for Medical, Dental, and Mental Health Care (Form P-2).pdf Form
P-2 Authorization for Medical, Dental, and Mental Health Car TAB D - Authorization for Medical, Dental, and Mental Health Care (Form P-2).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Authorization for Medical, Dental, and Mental Health Care (Form P-2)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	P-2	Authorization for Medical, Dental, and Mental Health Care	TAB D - Authorization for Medical, Dental, and Mental Health Care (Form P-2).pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: 09-80-0321 ORR Division of Children's Services Records	FR Citation: 81 FR 46682

Number of Respondents: 206	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	77,662	77,662
Annual IC Time Burden (Hours)	1,294	1,294
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.