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Dental Assessment Form - Recordkeeping Time
Medical Assessment Form and Dental Assessment Form
OMB: 0970-0466
IC ID: 261420
OMB.report
HHS/ACF
OMB 0970-0466
ICR 202308-0970-002
IC 261420
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0466 can be found here:
2023-12-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Dental Assessment Form - Recordkeeping Time
Form
1 Dental Assessment Form
ORR Dental Assessment Form.docx
Form
Attachment C_Dental Assessment Form Instructional Letter for Dental Providers.docx
Attachment C - Dental Assessment Form Instructional Letter for Dental Providers
IC Document
Information Collection (IC) Details
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