OPTN- Thoracic Follow-up

Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Data System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:

Documents and Forms

Document Name Document Type
Form 11b OPTN- Thoracic Follow-up Form
11b Thoracic Pediatric Follow-up TRF Thoracic 6 Month Pediatric Wksheet.pdf Form
11 Thoracic Follow-up TRF Thoracic 6 Month Adult Wksheet.pdf Form
11c Thoracic Follow-up Annual TRF Thoracic Adult Wksheet.pdf Form
11d Thoracic Follow-up Annual Pediatric TRF Thoracic Pediatric Wksheet.pdf Form
11e Post 5-Year Thoracic Follow-up TRF Post 5-Year All Organs Adult Wksheet.pdf Form
11f Post 5-Year Kidney Pediatric Follow-up TRF Post 5-Year All Organs Pediatric Wksheet.pdf Form
TRF Thoracic 6 Month Help.pdf Thoracic Follow-up Instructions IC Document
TRF Thoracic 6 Month Doc.pdf Thoracic Registration Changes IC Document
TRF Thoracic Help.pdf Thoracic Follow-up Annual Instructions IC Document
TRF All Organs Doc.pdf Thoracic Follow-up Annual Changes IC Document
TRF Post 5-Year All Organs Doc.pdf Post 5-Year Thoracic Changes IC Document
TRF Post 5-YearThoracic Help.pdf Post 5-Year Thoracic Instructions IC Document

Information Collection (IC) Details

IC Title:	OPTN- Thoracic Follow-up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	11b	Thoracic Pediatric Follow-up	TRF Thoracic 6 Month Pediatric Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	11	Thoracic Follow-up	TRF Thoracic 6 Month Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	11c	Thoracic Follow-up Annual	TRF Thoracic Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	11d	Thoracic Follow-up Annual Pediatric	TRF Thoracic Pediatric Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	11e	Post 5-Year Thoracic Follow-up	TRF Post 5-Year All Organs Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	11f	Post 5-Year Kidney Pediatric Follow-up	TRF Post 5-Year All Organs Pediatric Wksheet.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 135	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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30,915	30,915
Annual IC Time Burden (Hours)	12,768	12,768
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Thoracic Follow-up Instructions	TRF Thoracic 6 Month Help.pdf	07/18/2007
Thoracic Registration Changes	TRF Thoracic 6 Month Doc.pdf	07/18/2007
Thoracic Follow-up Annual Instructions	TRF Thoracic Help.pdf	07/20/2007
Thoracic Follow-up Annual Changes	TRF All Organs Doc.pdf	07/20/2007
Post 5-Year Thoracic Changes	TRF Post 5-Year All Organs Doc.pdf	07/23/2007
Post 5-Year Thoracic Instructions	TRF Post 5-YearThoracic Help.pdf	07/23/2007

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