Justification Document

Report of Dental Examination Form

OMB Control Number 0420-0550

Justification for No Material/Nonsubstantive Change

The Peace Corps Office of Health Services proposes to make changes to the Peace Corps Report of Dental Examination Form OMB Control Number: 0420-0550, submitted for OMB approval on August 23, 2024.

The changes are intended to clarify the instructions and simplify the questions and are based on the feedback that mental health providers do not understand what the Peace Corps is asking for, which results in incomplete or inadequate submission of information. Here is a summary of the changes:

1. Content edits

   1. Change link in footer from http://multimedia.peacecorps.gov/multimedia/pdf/policies/systemofrecords.pdf to https://files.peacecorps.gov/multimedia/pdf/policies/systemofrecords.pdf 

   2. Change address in footer from: 1111 20^th Street, NW Washington, DC, 20526 to the current address: 1275 First Street, NE, Washington, DC, 20526. 

2. Formatting edits

1. Move applicant name and DOB from the cover page to the first page of the form, to avoid having the cover page unnecessarily returned to the Peace Corps.

2. Slight modification to text in the various section of the form but not change to overall content.