View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

OPTN Membership Application for Heart Transplant Program
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 6 B OPTN Membership Application_Surgeon or Physician Log OPTN Membership Application Surgeon or Physician Log.docx Yes Yes Fillable Fileable
Form and Instruction 6 OPTN Membership Application for Heart Transplant Programs 09182023 - 06_OPTN Membership Application for Heart Transplant Programs - REDLINE.docx Yes Yes Fillable Fileable
Form and Instruction 6 06_OPTN Membership Application for Heart Transplant Programs CLEAN 10072024 06_OPTN Membership Application for Heart Transplant Programs CLEAN 10072024.docx Yes Yes Fillable Fileable
Form and Instruction 6 06_OPTN Membership Application for Heart Transplant Programs REDLINE 10072024 06_OPTN Membership Application for Heart Transplant Programs REDLINE 10072024.docx Yes Yes Fillable Fileable
Form and Instruction 6E (03.25 version) OPTN Membership Application for Heart Transplant Programs E_HSB_0915-0184_OPTN Membership Application for Heart Transplant Programs REDLINE.docx Yes Yes Fillable Fileable
Form and Instruction 6V (03.25 version) OPTN Membership Application Surgeon or Physician Log V_HSB_0915-0184_OPTN Membership Application Surgeon or Physician Log REDLINE.docx Yes Yes Fillable Fileable

Health Health Care Services

 

145 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 49 0 0 0 0 49
Annual IC Time Burden (Hours) 1,005 0 0 0 0 1,005
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.