OPTN- Living Donor 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⚠️ Notice: This information collection may be referencing outdated material.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 4 OPTN- Living Donor Follow-up Form
4 Living Donor Follow-up Living Donor Fol Wksheet.pdf Form
Living Donor Fol Help.pdf Living Donor Follow-up Instructions IC Document
Living Donor Follow-up.doc Living Donor Follow-up IC Document

Information Collection (IC) Details

IC Title:	OPTN- Living Donor Follow-up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	4	Living Donor Follow-up	Living Donor Fol 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: 308	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	Previously Approved
Annual Number of Responses for this IC	15,400	2,602	12,798
Annual IC Time Burden (Hours)	7,700	3,477	4,223
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Living Donor Follow-up Instructions	Living Donor Fol Help.pdf	07/17/2007
Living Donor Follow-up	Living Donor Follow-up.doc	09/14/2010

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