OMB control number

[NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS)

OMB 0920-1289 · HHS/CDC.

OMB 0920-1289

By age 19, 67% of U.S. adolescents living in poverty have experienced tooth decay and 27% have at least one decayed tooth needing treatment. School sealant programs provide dental sealants, which protect against 80% of cavities for two years, and continue to protect against 50% of cavities for up to four years. CDC requests information from states regarding children's cavity risk, one-year sealant retention rate, sealant program services delivered, and school sealant program cost and quantity of resources used at each school event. This data will allow CDC and states to monitor the performance and efficiency of their school sealant programs, which will improve and extend program delivery to more children.

The latest form for [NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS) expires 2026-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1289 Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction
Form 0920-1289 Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction
Form 0920-1289 SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction
Form 0920-1289 Add Program and Add User - State Sealant Administrator Form and Instruction
SEALS SSB Final.docx Supporting Statement B
SEALS SSA.101123.docx Supporting Statement A
SEALS PIA Final.pdf Supplementary Document
SEALS IRB Determination.pdf Supplementary Document
2c. Sample Reports.xlsx Supplementary Document
1_Legislation.pdf Supplementary Document
3 SEALS 60dy published FRN.pdf Supplementary Document
Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction
Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction
SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction
Add Program and Add User - State Sealant Administrator Form and Instruction

All Historical Document Collections

202309-0920-005 Approved without change	Reinstatement with change of a previously approved collection	2023-10-31
201910-0920-011 Approved without change	Existing collection in use without an OMB Control Number	2019-11-20

OMB Details

Add Program and Add User - State Sealant Administrator

Federal Enterprise Architecture: Health - Illness Prevention

Form 0920-1289

SEALS Administration - Child Aggregate Screens

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.