OMB control number

Report of Dental Examinitaion

OMB 0420-0546 · PEACE.

OMB 0420-0546

The Peace Corps Office of Medical Services is responsible for the collection of applicant dental information, using the Report of Dental Exam form. The Dental Exam form is completed by the applicant and the applicant's examining dentist. The results of the examinations are used to ensure that applicants for Volunteer service will, with reasonable accommodation, be able to serve in the Peace Corps without jeopardizing their health.

The latest form for Report of Dental Examinitaion expires 2027-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form PC-OMS-1790 Dental Report of Dental Evaluation Form and Instruction
Report_of_Dental_Evaluation_Justification.docx Justification for No Material/Nonsubstantive Change
PC-17.pdf Supplementary Document
Supporting Statement A 0420-0546 Report of Dental Examination.docx Supporting Statement A
Report of Dental Evaluation Form and Instruction

All Historical Document Collections

202408-0420-002	Reinstatement without change of a previously approved collection	2024-08-23
202011-0420-007	Reinstatement without change of a previously approved collection	2020-11-17
201610-0420-004 Approved without change	Revision of a currently approved collection	2017-01-31
201410-0420-002 Approved with change	Reinstatement without change of a previously approved collection	2014-10-14
201106-0420-002 Approved with change	New collection (Request for a new OMB Control Number)	2011-07-01