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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Death Notification Registration
New
10589
4447
0
Instruction
Form
66
Death Notification Registration
Deceased Donor Death Referral
New
3069
1535
0
Instruction
Form and Instruction
67
Deceased Donor Death Referral
Deceased Donor Registration (DDR)
Modified
13883
16660
0
Instruction
Form
1
Deceased Donor Registration_Form_Clean.xlsx
Other-Redline
Other-Redline
Disease Transmission Event
Modified
557
345
0
Instruction
Form
58
Disease Transmission Event_Form.xlsx
Donor Histocompatibility Form
Modified
21034
4207
0
Instruction
Form
4
Donor Histocompatibility_Form_Clean.xlsx
Other-Redline
Donor Hospital Registration
New
2
0
0
Instruction
Form
68
Donor Hospital Registration
Donor Organ Disposition
New
19136
3253
0
Instruction
Form
69
Donor Organ Disposition
Heart Follow Up (6 months)
Modified
3538
1415
0
Instruction
Form
8
Heart Transplant Recipient Follow Up 6 Month_Form.xlsx
Heart Post-Transplant Malignancy Form
Modified
1910
1719
0
Instruction
Form
11
Heart Post Transplant Malignancy_Form.xlsx
Heart Recepient Registration
Modified
3816
7479
0
Instruction
Form
7
Heart Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Heart Transplant Candidate Registration (TCR)
Modified
5016
4514
0
Instruction
Form
6
Heart Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-Redline
Heart Transplant Recipient Follow Up 1-5 Year
Modified
15100
13590
0
Instruction
Form
9
Heart Transplant Recipient Follow Up 1_5 Year _Form_Clean.xlsx
Other-Redline
Heart Transplant Recipient Follow Up Post 5 Year
Modified
24810
12405
0
Instruction
Form
10
Heart Transplant Recipient Follow Up Post 5 Year_Form_Clean.xlsx
Other-Redline
Heart/Lung Post Transplant Malignancy (PTM) Form
Modified
20
8
0
Instruction
Form
23
HeartLung Post Transplant Malignancy_Form.xlsx
Heart/Lung Recipient Registration
Modified
45
97
0
Instruction
Form
19
Heart/Lung Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Heart/Lung Transplant Candidate Registration (TCR)
Modified
67
74
0
Instruction
Form
18
Heart/Lung Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-Redline
Heart/Lung Transplant Recipient Follow Up 1-5 Year (TRF)
Modified
147
162
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
42
34
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
235
141
0
Instruction
Form
22
Heart/Lung Transplant Recipient Follow Up Post 5 Year_Form.xlsx
Initial Donor Registration
New
19136
57408
0
Instruction
Form
63
Initial Donor Registration
Intestine Post Transplant Malignancy (PTM) Form
Modified
13
13
0
Instruction
Form
34
Intestine Post Transplant Malignancy_Form.xlsx
Intestine Transplant Candidate Registration (TCR)
Modified
144
187
0
Instruction
Form
30
Intestine Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-Redline
Intestine Transplant Recipient Follow Up 6 Month -5 Year (TRF)
Modified
421
632
0
Instruction
Form
32
Intestine Transplant Recipient Follow Up 6 Month_5 Year_Form_clean.xlsx
Other-Redline
Intestine Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
844
338
0
Instruction
Form
33
Liver Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Other-Redline
Intestine Transplant Recipient Registration (TRR)
Modified
96
173
0
Instruction
Form
31
Intestine Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Kidney Paired Donation Candidate Registration
Modified
191
55
0
Instruction
Form
55
Kidney Paired Donation Candidate Registration_Form_clean.xlsx
Other-redline
Kidney Paired Donation Donor Registration
Modified
248
268
0
Instruction
Form
56
Kidney Paired Donation Donor Registration_Form_clean.xlsx
Other-redline
Other-redline
Kidney Paired Donation Match Offer Management
Modified
242
162
0
Instruction
Form
57
Kidney Paired Donation Match Offer Management_Form.xlsx
Kidney Post Transplant Malignancy (PTM) Form
Modified
5726
4581
0
Instruction
Form
39
Kidney Post Transplant Malignancy_Form.xlsx
Kidney Transplant Candidate Registration (TCR)
Modified
41418
33134
0
Instruction
Form
35
Kidney Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-redline
Kidney Transplant Recipient Follow Up 6 Month -5 Year (TRF)
Modified
121006
108905
0
Instruction
Form
37
Kidney Transplant Recipient Follow Up 6 Month_5 Year_Form_clean.xlsx
Other-Redline
Kidney Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
122873
61437
0
Instruction
Form
38
Kidney Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Other-Redline
Kidney Transplant Recipient Registration (TRR)
Modified
24664
29597
0
Instruction
Form
36
Kidney Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Kidney/Pancreas Post Transplant Malignancy (PTM) Form
Modified
299
120
0
Instruction
Form
49
Kidney/Pancreas Post Transplant Malignancy_Form.xlsx
Kidney/Pancreas Transplant Candidate Registration (TCR)
Modified
1494
896
0
Instruction
Form
45
Kidney/Pancreas Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-Redline
Kidney/Pancreas Transplant Recipient Follow Up 6 Month -5 Year (TRF)
Modified
4733
2367
0
Instruction
Form
47
Kidney/Pancreas Transplant Recipient Follow Up 6 Month_5 Year_Form_clean.xlsx
Other-Redline
Kidney/Pancreas Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
8329
4997
0
Instruction
Form
48
Kidney/Pancreas Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Other-redline
Kidney/Pancreas Transplant Recipient Registration (TRR)
Modified
821
985
0
Instruction
Form
46
Kidney/Pancreas Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Liver Post Transplant Malignancy (PTM) Form
Modified
2726
2181
0
Instruction
Form
29
Liver Post Transplant Malignancy_Form.xlsx
Liver Recipient Explant Pathology Form
Modified
1044
626
0
Instruction
Form
28
Liver Explant Pathology Form.xlsx
Liver Transplant Candidate Registration (TCR)
Modified
13860
11088
0
Instruction
Form
24
Liver Transplant Candidate Registration_Form.xlsx
Other-Redline
Other-Redline
Liver Transplant Recipient Follow Up 6 Month -5 Year (TRF)
Modified
45799
45799
0
Instruction
Form
26
Liver Transplant Recipient Follow Up 6 Month_5 Year_Form_clean.xlsx
Other-Redline
Liver Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
54958
27479
0
Instruction
Form
27
Liver Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Other-Redline
Liver Transplant Recipient Registration (TRR)
Modified
9235
11082
0
Instruction
Form
25
Liver Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Living Donor Event
Modified
39
22
0
Instruction
Form
59
Living Donor Event_Form.xlsx
Living Donor Follow-up (LDF)
Modified
19559
29730
0
Instruction
Form
3
Living Donor Follow Up_Form_Clean.xlsx
Other-Redline
Living Donor Registration (LDR)
Modified
6072
13298
0
Instruction
Form
2
Living Donor Registration_Form_clean
Other-Redline
Other-Redline
Lung - Post Transplant Malignancy (PTM) Form
Modified
1629
652
0
Instruction
Form
17
Lung Post Transplant Malignancy_Form.xlsx
Lung Transplant Candidate Registration (TCR)
Modified
3094
2785
0
Instruction
Form
12
Lung Transplant Candidate Registration_Form
Other-Redline
Lung Transplant Recipient Follow Up 1-5 Year (TRF)
Modified
10076
11084
0
Instruction
Form
15
Lung Transplant Recipient Follow Up 1_5 Year_Form
Lung Transplant Recipient Follow Up 6 Month (TRF)
Modified
2421
1211
0
Instruction
Form
14
Lung Transplant Recipient Follow Up 6 Month_Form.xlsx
Lung Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
9812
5887
0
Instruction
Form
16
Lung Transplant Recipient Follow Up Post 5 Year_Form
Lung Transplant Recipient Registration (TRR)
Modified
2521
3025
0
Instruction
Form
13
Lung Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
OPO Notification Limit Administration
New
28
5
0
Instruction
Form
64
OPO Notification Limit Administration
Organ Labeling and Packaging System
Modified
14120
2542
0
Instruction
Form
53
Organ Labeling and Packaging_Form.xlsx
Organ Tracking and Validating System
Modified
6003
480
0
Instruction
Form
54
Organ Tracking and Validating_Form.xlsx
Pancreas Post Transplant Malignancy (PTM) Form
Modified
127
76
0
Instruction
Form
44
Pancreas Post Transplant Malignancy_Form.xlsx
Pancreas Transplant Candidate Registration (TCR)
Modified
318
191
0
Instruction
Form
40
Pancreas Transplant Candidate Registration_Form_clean.xlsx
Other-Redline
Other-Redline
Pancreas Transplant Recipient Follow Up 6 Month -5 Year (TRF)
Modified
802
401
0
Instruction
Form
42
Pancreas Transplant Recipient Follow Up 6 Month_5 Year_Form_clean.xlsx
Other-Redline
Pancreas Transplant Recipient Follow Up Post 5 Year (TRF)
Modified
2138
1069
0
Instruction
Form
43
Pancreas Transplant Recipient Follow Up Post 5 Year_ Form_clean.xlsx
Other-redline
Pancreas Transplant Recipient Registration (TRR)
Modified
143
172
0
Instruction
Form
41
Pancreas Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Potential Disease Transmission Report
Modified
497
631
0
Instruction
Form
61
Potential Disease Transmission Report_Form.xlsx
Potential Transplant Recipient
New
1453292
72665
0
Instruction
Form
65
Potential Transplant Recipient
Recipient Histocompatibility Form
Modified
37358
14943
0
Instruction
Form
5
Recipient Histocompatibility_Form._Clean.xlsx
Other-Redline
Request to Unlock Form
Modified
19038
381
0
Instruction
Form
62
Request to Unlock Form_Form.xlsx
Safety Situation
Modified
269
151
0
Instruction
Form
60
Safety Situation_Form.xlsx
Transplant Center Contact Management
New
160013
9601
0
Instruction
Form and Instruction
70
Transplant Center Contact Management
VCA Transplant Candidate Registration (TCR)
Modified
7
3
0
Instruction
Form
50
VCA Transplant Candidate Registration_Form.xlsx
VCA Transplant Recipient Follow Up (TRF)
Modified
21
28
0
Instruction
Form
52
VCA Transplant Recipient Follow Up_Form_clean.xlsx
Other-redline
VCA Transplant Recipient Registration (TRR)
Modified
4
5
0
Instruction
Form
51
VCA Transplant Recipient Registration_Form_clean.xlsx
Other-Redline
Total burden requested under this ICR:
2352737
647633
0
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