Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Death Notification Referal - Eligible Removed 0 0 0 Form 1
Instruction
Death Notification Referral-Imminent Removed 0 0 0 Form 1
Instruction
Death Referral Data Removed 0 0 0 Form 1
Instruction
Heart, Lung, Heart/Lung Follow Up (1-5 year) New 16139 17753 0 Form and Instruction 21
Heart, Lung, Heart/Lung Follow Up (6 month) New 3923 3138 0 Form and Instruction 20
Heart, Lung, Heart/Lung Follow Up (Post 5 year) New 19485 11691 0 Form and Instruction 22
Heart, Lung, Heart/Lung Recipient Registration New 4471 6259 0 Form and Instruction 19
Kidney/Pancreas Modified 25029 21188 0 Form and Instruction 45
Form and Instruction 46
Form and Instruction 47
Form and Instruction 48
Liver Explant Pathology Removed 0 0 0 Form 1
Instruction
Liver Recipient Explant Pathology Form New 1659 995 0 Form and Instruction 28
OPTN- Deceased Donor Registration Worksheet Modified 9176 10093 0 Form and Instruction 1
OPTN- Donor Histocompatibility Modified 14599 2920 0 Form and Instruction 4
OPTN- Heart Candidate Registration Modified 3996 3596 0 Form and Instruction 6
OPTN- Heart/Lung Candidate Registration Modified 44 48 0 Form and Instruction 18
OPTN- Intestine Candidate Registration Modified 180 234 0 Form and Instruction 30
OPTN- Intestine Follow-up Modified 1099 1040 0 Form and Instruction 32
Form and Instruction 33
OPTN- Intestine Recipient Registration Modified 111 200 0 Form and Instruction 31
OPTN- Kidney Candidate Registration Modified 37882 30306 0 Form and Instruction 35
OPTN- Kidney Follow-up Modified 169200 119972 0 Form and Instruction 37
Form and Instruction 38
OPTN- Kidney Recipient Registration Modified 16897 21966 0 Form and Instruction 36
OPTN- Kidney/Pancreas Registration Removed 0 0 0 Instruction
Form 19
Form 19b
OPTN- Liver Candidate Registration Modified 12050 9640 0 Form and Instruction 24
OPTN- Liver Follow-up Modified 65824 48511 0 Form and Instruction 26
Form and Instruction 27
OPTN- Liver Recipient Registration Modified 6460 8398 0 Form and Instruction 25
OPTN- Living Donor Registration Modified 5979 10763 0 Form and Instruction 2
OPTN- Lung Candidate Registration Modified 2535 2282 0 Form and Instruction 12
OPTN- Pancreas Follow-up Removed 0 0 0 Instruction
Instruction
Form 23
Form 23b
Form 23c
Form 23d
OPTN- Pancreas Registration Removed 0 0 0 Instruction
Form 22
Form 22b
OPTN- Post Transplant Malignancy Removed 0 0 0 Instruction
Form 27
Form 27b
OPTN- Recipient Histocompatibility Modified 26195 10478 0 Form and Instruction 5
OPTN- Thoracic Follow-up Removed 0 0 0 Form 1
Form 2
Form 5
Form 7
Form 8
Form 11
Form 13
Form 14
Form 17
Instruction
Instruction
Instruction
Form 3
Form 4
Form 6
Form 9
Form 10
Form 12
Form 15
Form 16
Form 18
OPTN- Thoracic Registration Removed 0 0 0 Instruction
Form 10
Form 10b
Form 10c
Form 10d
Form 10e
Form 10f
OPTN- Kidney/Pancreas Follow-up Removed 0 0 0 Instruction
Instruction
Form 20
Form 20b
Form 20c
Form 20d
OPTN- Living Donor Follow-up Modified 17612 22896 0 Form and Instruction 3
Pancreas Modified 3942 3016 0 Form and Instruction 40
Form and Instruction 41
Form and Instruction 42
Form and Instruction 43
Pancreas Islet Candidate Registration Removed 0 0 0 Form 1
Form 2
Instruction
Post-Transplant Malignancy Form New 7888 6307 0 Form and Instruction 11
Vascular Composite Allograft New 43 39 0 Form and Instruction 50
Instruction
Form and Instruction 51
Form and Instruction 52
Total burden requested under this ICR: 472418 373729 0  
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