The bottom line. HHS proposes consolidating three health-related forms for unaccompanied alien children into one information collection and would share certain health data with DHS when a child is repatriated. Comments are due October 5, 2026.

The Administration for Children and Families (ACF) Office of Refugee Resettlement (ORR) published a notice in the Federal Register on August 5, 2026, requesting public comment on consolidating the Serious Medical Procedure Request (SMR) form into the existing Medical Assessment Form and Dental Assessment Form collection, and renaming it the ORR Unaccompanied Alien Child Health Forms.

The proposal would revise the forms to reduce duplicate documentation, improve data quality, and align with ORR requirements. ORR also proposes sharing relevant health information with the Department of Homeland Security (DHS) when a child with healthcare needs is identified for repatriation, to ensure continuity of care.

What the Rule Changes

The SMR form, currently approved under OMB # 0970-0561, would move under OMB # 0970-0466, which currently covers the Medical Assessment Form (MAF) and Dental Assessment Form (DAF). The SMR form's first page, previously completed by care provider staff, would be removed, and fields would be revised to reduce redundancy.

The MAF and DAF would be updated to require the History section on the DAF only for the initial dental exam, allow healthcare providers to summarize critical health information instead of completing a third page for most visits, strengthen the disabilities and accommodations field, add a field for labs and imaging, and replace fixed diagnosis choices with free-text fields. A healthcare provider signature section would authorize record sharing with ORR.

Data Sharing With DHS

ORR would share health data with DHS when a child in ORR custody has healthcare needs and is identified by DHS for repatriation. The shared information includes the child's identifying information (name, alien number, date of birth), active diagnoses, allergies, current medications and dosages, isolation or quarantine requirements, health-related accommodations (including durable medical equipment needs), and health-related travel restrictions.

Burden Estimates

ORR estimates the annual burden for respondents at 5,202 hours, down 91.5 percent from the current collection, and recordkeeping burden at 12,015.4 hours, down 88 percent. The decrease is attributed to a lower census of unaccompanied children in ORR care and streamlined forms. The estimates cover 150 pediatricians, 300 medical specialists, 150 dentists, and 150 surgeons as respondents, with recordkeeping performed by care provider staff.

What This Means Right Now

  • Care providers and healthcare providers working with unaccompanied children may see revised forms with fewer required fields and clearer instructions by visit type.

  • Healthcare providers may need to document labs, imaging, and accommodations more explicitly on the Medical Assessment Form.

  • When a child with healthcare needs is repatriated, DHS may receive limited health information to support continuity of care.

  • Public comments on the proposed changes must be submitted by October 5, 2026.

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