Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Deceased Donor Registration (DDR) Modified 10262 11288 0 Instruction
Form and Instruction 1 UPDATED -Copy of Copy of Deceased Donor Registration Form-Jan2017.xlsx
Donor Histocompatibility Form Modified 15611 3122 0 Instruction
Form 4 Donor Histocompatibility _Form.xlsx
Heart Follow Up (6 months) New 2261 904 0 Instruction
Form 8 Heart Transplant Recipient Follow Up 6 Month_Form.xlsx
Heart Post-Transplant Malignancy Form New 1623 1461 0 Instruction
Form 11 Post Transplant Malignancy Form_All Organs.xlsx
Heart Recepient Registration New 2805 3366 0 Instruction
Form 7 Heart Transplant Recipient Registration_Form.xlsx
Heart Transplant Candidate Registration (TCR) Modified 4439 3995 0 Instruction
Form 6 Heart Transplant Candidate Registration_Form.xlsx
Heart Transplant Recipient Follow Up 1-5 Year New 10595 9536 0 Instruction
Form 9 Heart Transplant Recipient Follow Up 1-5 Year_Form.xlsx
Heart Transplant Recipient Follow Up Post 5 Year New 16085 8043 0 Instruction
Form 10 Heart Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Heart/Lung Post Transplant Malignancy (PTM) Form New 21 8 0 Instruction
Form 23 Post Transplant Malignancy Form_All Organs.xlsx
Heart/Lung Recipient Registration Modified 14 18 0 Instruction
Form 19 Heart_Lung Transplant Recipient Registration_Form.xlsx
Heart/Lung Transplant Candidate Registration (TCR) Modified 46 51 0 Instruction
Form 18 Heart_Lung Transplant Candidate Registration_Form.xlsx
Heart/Lung Transplant Recipient Follow Up 1-5 Year (TRF) Modified 94 103 0 Instruction
Form 21 Heart_Lung Transplant Recipient Follow Up 1-5 Year_Form.xlsx
Heart/Lung Transplant Recipient Follow Up 6 Month (TRF) Modified 13 10 0 Instruction
Form 20 Heart_Lung Transplant Recipient Follow Up 6 Month_Form.xlsx
Heart/Lung Transplant Recipient Follow Up Post 5 Year (TRF) Modified 199 119 0 Instruction
Form 22 Heart_Lung Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Intestine Post Transplant Malignancy (PTM) Form New 24 24 0 Instruction
Form 34 Post Transplant Malignancy Form_All Organs.xlsx
Intestine Transplant Candidate Registration (TCR) Modified 200 260 0 Instruction
Form 30 Intestine Transplant Candidate Registration_Form.xlsx
Intestine Transplant Recipient Follow Up 6 Month -5 Year (TRF) Modified 530 795 0 Instruction
Form 32 Intestine Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Intestine Transplant Recipient Follow Up Post 5 Year (TRF) New 655 262 0 Instruction
Form 33 Intestine Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Intestine Transplant Recipient Registration (TRR) Modified 141 254 0 Instruction
Form 31 Intestine Transplant Recipient Registration_Form.xlsx
Kidney Post Transplant Malignancy (PTM) Form New 5327 4262 0 Instruction
Form 39 Post Transplant Malignancy Form_All Organs.xlsx
Kidney Transplant Candidate Registration (TCR) Modified 36076 28861 0 Instruction
Form 35 Kidney Transplant Candidate Registration_Form.xlsx
Kidney Transplant Recipient Follow Up 6 Month -5 Year (TRF) Modified 91234 82111 0 Instruction
Form 37 Kidney Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Kidney Transplant Recipient Follow Up Post 5 Year (TRF) New 89453 44727 0 Instruction
Form 38 Kidney Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Kidney Transplant Recipient Registration (TRR) Modified 17899 21479 0 Instruction
Form 36 Kidney Transplant Recipient Registration_Form.xlsx
Kidney/Pancreas Post Transplant Malignancy (PTM) Form New 283 113 0 Instruction
Form 49 Post Transplant Malignancy Form_All Organs.xlsx
Kidney/Pancreas Transplant Candidate Registration (TCR) Modified 1265 759 0 Instruction
Form 45 Kidney_Pancreas Transplant Candidate Registration_Form.xlsx
Kidney/Pancreas Transplant Recipient Follow Up 6 Month -5 Year (TRF) New 4262 2131 0 Instruction
Form 47 Kidney_Pancreas Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Kidney/Pancreas Transplant Recipient Follow Up Post 5 Year (TRF) New 6876 4126 0 Instruction
Form 48 Kidney_Pancreas Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Kidney/Pancreas Transplant Recipient Registration (TRR) New 718 862 0 Instruction
Form 46 Kidney_Pancreas Transplant Recipient Registration_Form.xlsx
Liver Post Transplant Malignancy (PTM) Form New 1985 1588 0 Instruction
Form 29 Post Transplant Malignancy Form_All Organs.xlsx
Liver Recipient Explant Pathology Form Modified 1812 1087 0 Instruction
Form 28 Liver Recipient Explant Pathology_Form.xlsx
Liver Transplant Candidate Registration (TCR) Modified 12026 9621 0 Instruction
Form 24 Liver Transplant Candidate Registration_Form.xlsx
Liver Transplant Recipient Follow Up 6 Month -5 Year (TRF) Modified 32985 32985 0 Instruction
Form 26 Liver Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Liver Transplant Recipient Follow Up Post 5 Year (TRF) New 39108 19554 0 Instruction
Form 27 Liver Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Liver Transplant Recipient Registration (TRR) Modified 7125 8550 0 Instruction
Form 25 Liver Transplant Recipient Registration_Form.xlsx
Living Donor Follow-up (LDF) Modified 17686 22992 0 Instruction
Form 3 Living Donor Follow Up Form.xlsx
Living Donor Registration (LDR) Modified 5936 10685 0 Instruction
Form 2 Living Donor Registration Form.xlsx
Lung - Post Transplant Malignancy (PTM) Form New 1106 442 0 Instruction
Form 17 Post Transplant Malignancy Form_All Organs.xlsx
Lung Transplant Candidate Registration (TCR) Modified 2592 2333 0 Instruction
Form 12 Lung Transplant Candidate Registration_Form.xlsx
Lung Transplant Recipient Follow Up 1-5 Year (TRF) New 6939 7633 0 Instruction
Form 15 Heart_Lung Transplant Recipient Follow Up 1-5 Year_Instructions.docx
Lung Transplant Recipient Follow Up 6 Month (TRF) New 1809 905 0 Instruction
Form 14 Liver Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Lung Transplant Recipient Follow Up Post 5 Year (TRF) New 4898 2939 0 Instruction
Form 16 Lung Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Lung Transplant Recipient Registration (TRR) New 2058 2470 0 Instruction
Form 13 Lung Transplant Recipient Registration_Form.xlsx
Pancreas Post Transplant Malignancy (PTM) Form New 120 72 0 Instruction
Form 44 Post Transplant Malignancy Form_All Organs.xlsx
Pancreas Transplant Candidate Registration (TCR) Modified 389 233 0 Instruction
Form 40 Pancreas Transplant Candidate Registration_Form.xlsx
Pancreas Transplant Recipient Follow Up 6 Month -5 Year (TRF) New 1252 626 0 Instruction
Form 42 Pancreas Transplant Recipient Follow Up 6 Month-5 Year_Form.xlsx
Pancreas Transplant Recipient Follow Up Post 5 Year (TRF) New 1953 977 0 Instruction
Form 43 Pancreas Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Pancreas Transplant Recipient Registration (TRR) New 233 280 0 Instruction
Form 41 Pancreas Transplant Recipient Registration_Form.xlsx
Post-Transplant Malignancy Form Removed 0 0 0 Form and Instruction 11 Post-Transplant Malignancy Form
Recipient Histocompatibility Form Modified 27810 11124 0 Instruction
Form 5 Recipient Histocompatibility_Form.xlsx
VCA Transplant Candidate Registration (TCR) Modified 49 20 0 Instruction
Form 50 Vascular Composite Allograft (VCA) Transplant Candidate Registration_Form.xlsx
VCA Transplant Recipient Follow Up (TRF) New 49 49 0 Instruction
Form 52 Vascular Composite Allograft Transplant Recipient Follow Up_Form.xlsx
VCA Transplant Recipient Registration (TRR) New 49 64 0 Instruction
Form 51 Vascular Composite Allograft Transplant Recipient Registration_Form.xlsx
Total burden requested under this ICR: 488980 370279 0  
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