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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
OPTN- Thoracic Follow-up
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
Thoracic Heart Adult 6 month Follow-up
Thoracic Heart Adult 6 Month Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
2
Thoracic Heart Adult Post 5 year
Thoracic Heart Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
5
Thoracic Heart Pediatric Post 5 Follow Up
Thoracic Heart Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
7
Thoracic Heart Lung Adult Six month
Thoracic Heart-Lung Adult 6 Month Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
8
Thoracic Heart Lung Adult Post 5
Thoracic Heart-Lung Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
11
Thoracic Heart Lung Pediatric Post 5
Thoracic Heart-Lung Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
13
Thoracic Lung Adult 6 month Follow UP
Thoracic Lung Adult 6 Month Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
14
Thoracic Lung Adult Post 5 Follow Up
Thoracic Lung Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
17
Thoracic Lung Pediatric Post 5
Thoracic Lung Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf
Yes
Yes
Fillable Fileable
Instruction
Thoracic 6 Month Transplant Recipient Follow Up Instructions.pdf
Yes
No
Printable Only
Instruction
Thoracic Post 5 Year Transplant Recipient Follow Up Instructions.pdf
Yes
No
Printable Only
Instruction
Thoracic Transplant Recipient Follow Up Instructions.pdf
Yes
No
Printable Only
Form
3
Thoracic Heart Adult Transplant Recipient Follow Up
Thoracic_Heart_Adult_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
4
Thoracic Heart Pediatric 6 Month Transplant Recipient Follow Up
Thoracic_Heart_Pediatric_6_Month_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
6
Thoracic Heart Pediatric Transplant Recipient Follow Up
Thoracic_Heart_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
No
Fillable Fileable
Form
9
Thoracic Heart Lung Adult Transplant Recipient Follow Up
Thoracic_Heart-Lung_Adult_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
10
Thoracic Heart Lung Pediatric 6 Month Transplant Recipient Follow Up
Thoracic_Heart-Lung_Pediatric_6_Month_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
12
Thoracic Heart Lung Pediatric Transplant Recipient Follow Up
Thoracic_Heart-Lung_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
15
Thoracic Lung Adult Transplant Recipient Follow Up
Thoracic_Lung_Adult_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Form
16
Thoracic Lung Pediatric 6 Month Transplant Recipient Follow Up
Thoracic_Lung_Pediatric_6_Month_Transplant_Recipient_Follow_Up_Worksheet.pdf
Yes
Yes
Fillable Fileable
Form
18
Thoracic Lung Pediatric Transplant Recipient Follow Up
Thoracic_Lung_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
131
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
-36,287
0
0
36,287
Annual IC Time Burden (Hours)
0
0
-23,587
0
0
23,587
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.