Dear Colleagues letter -Dental

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XX/XX/2026





Dear Colleague,

Thank you for evaluating this child who is in the custody of the Office of Refugee Resettlement (ORR), a program administered by the U.S. Department of Health and Human Services (HHS). ORR is responsible for ensuring the child’s health and safety while they are in Federal care. See 6 U.S.C. 279; 8 U.S.C. 1232, and 45 C.F.R. part 410. While in ORR custody, children are placed in ORR-funded care provider programs that are responsible for providing day-to-day care. We ask for your help in providing clear documentation of the health care you provide and any recommended follow-up that may be needed while the child is in ORR custody or after unification with their sponsor. Not all children will have access to health insurance or to highly specialized care after unification.

All sections of ORR’s Dental Assessment Form (DAF) must be completed by the evaluating dental provider by the conclusion of each dental visit, including the initial dental exam (IDE). Responses must include as much detail as possible to ensure the child’s needs are fully documented and addressed. Please note the DAF is a tool designed to capture relevant information collected during a comprehensive dental encounter that will assist ORR in ensuring children receive the appropriate healthcare. If the paper version of the DAF is used during the visit, the completed form must be given to the care provider program staff member with the child at the end of the visit.
Section Specific Guidance:
    • Child & Visit Information - 
    • Interpretation services: If the evaluating healthcare provider or their staff are not fluent in the child’s preferred language, ORR requires the use of a qualified interpreter either in-person or remotely.  
    • Assessment & Plan - 
        ◦ Diagnosis referrals/Follow-up: Specify recommended follow-up care, including referral details, timeframes (e.g., “within 2 weeks,” “4–6 months”), and scheduled appointment dates if applicable. If a child requires evaluation in the emergency room, please clearly indicate that an immediate/urgent referral is needed.
        ◦ Medications: A corresponding diagnosis must be documented for all prescribed and administered medications.
    • Travel restrictions: The physical location of a child in ORR care may change quickly for a variety of reasons (e.g., unification with sponsor, turning 18 years of age, transfer to another care program, or returning to country of origin). If the child has dental needs that could delay or otherwise affect their ability to travel, document all restrictions or requirements needed to ensure safe transit. For example, “No travel until child has been fever-free for 24 hours without antipyretic medications”. Note, a child may be fit to travel despite needing additional follow-up care (e.g., referrals, imaging) provided all urgent health needs have been addressed and an appropriate plan is in place to ensure their safety during travel.

Key Reminders:
    • Please provide copies of ALL health records (office notes, imaging reports, lab results, etc.) either directly to care provider program staff or uploaded to ORR’s electronic system of record by the end of the visit (or as soon as possible after the visit).
    • Ensure that all information, including your signature and printed name, written on the paper version of the DAF is legible and complete.

If you have questions about the DAF, need additional guidance, or have concerns regarding the information collected, please contact the Division of Health in the ORR’s Unaccompanied Alien Children Bureau (UACB) at [email protected]. For more information about the UACB, visit: https://acf.gov/orr/programs/uac. 

Thank you for your support and collaboration in providing high-quality care to the children in our care. 


Director (Acting), Division of Health 
Unaccompanied Alien Children Bureau / Office of Refugee Resettlement 
Administration for Children and Families / U.S. Department of Health and Human Services