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

Placement and Transfer of Unaccompanied Children into ORR Care Provider Facilities

⚠️ Notice: This information collection may be referencing outdated material.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 and Instruction
P-2 Authorization for Medical, Dental, and Mental Health Car Authorization for Medical, Dental, and Mental Health Care (Form P-2) - UC Path.pdf Form and Instruction
P-2 Authorization for Medical, Dental, and Mental Health Car Authorization for Medical, Dental, and Mental Health Care (Form P-2) - UC Path.pdf Form and Instruction

Information Collection (IC) Details

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: Modified

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 and Instruction	P-2	Authorization for Medical, Dental, and Mental Health Care - UC Path Version	Authorization for Medical, Dental, and Mental Health Care (Form P-2) - UC Path.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: 262	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: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	140,432	80,384	60,048
Annual IC Time Burden (Hours)	11,235	6,231	5,004
Annual IC Cost Burden (Dollars)	0	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.