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Organ Procurement and Transplantation Network Application
 
No Modified
 
Mandatory
 
42 CFR 121

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0 0 A10_LDK_TX_program_appl_initial only.pdf www.optn.org Yes No Printable Only
Form 0 0 B2_New_LDL_only_Cover_Instructions_Add on program.pdf www.optn.org Yes No Printable Only
Form and Instruction 1 A1_Full_App_Cover_Instructions A1_Full Appl_Cover_instructions_2010_Nov.doc www.optn.org Yes No Printable Only
Form 4 A4_LI_LDL_combined_app A4_LI_LDL_combined_appl_2010_Nov.doc Yes No Printable Only
Form 2 A2_part_1_2_General_facility A2_Part 1_2_General_Facility.doc www.optn.org Yes No Printable Only
Form 3 A3_KI_LDK_Combined_app A3_KI_LDK_combined appl_2010_Nov.doc www.optn.org Yes No Printable Only
Form 5 A5_PA_app A5_PA_appl_2010_Nov.doc Yes No Printable Only
Form 6 A6_HR_App A6_HR_appl_2010_Nov 22.doc www.optn.org Yes No Printable Only
Form 7 A7_LU_App A7_LU_appl_2010_Nov 18.doc www.optn.org Yes No Printable Only
Form 8 C_OPO_App C_OPO_application_independent_2010_Nov.doc www.optn.og Yes No Printable Only
Form 9 A8_HL_App A8_HL_appl_2010_Nov.doc www.optn.org Yes No Printable Only
Form 10 A9_PI_App A9_PI_appl_2010_Nov.doc www.optn.org Yes No Printable Only
Form 11 A10_OPO_Inhouse A10_OPO_inhouse_2010_Nov_Part 5.doc www.optn.org Yes No Printable Only
Form 13 A12_Lab_section_part_6 A_11_Hospital based Lab_Part 6 Appl_2010_Nov.doc www.optn.org Yes No Printable Only
Instruction B1_Cover_Instuctions_Add on program_2010_Nov.doc www.optn.org Yes No Printable Only
Form 14 E_Lab_Independent_app E_Lab_Independent_Application_2010_Nov.doc www.optn.org Yes No Printable Only
Form 15 B2_NewLDL_only_Cover_instructions D_LAB_inhouse_appl_cover_and_Instructions_2010_Nov.doc www.optn.org Yes No Printable Only

Health Public Health Monitoring

 

40 0
   
Private Sector Not-for-profit institutions
 
   0 %

  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 120 0 0 80 0 40
Annual IC Time Burden (Hours) 1,800 0 0 0 0 1,800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.