OPTN- Intestine 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⚠️ Notice: This information collection may be referencing outdated material.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 26b OPTN- Intestine Follow-up Form
26b Intestine Pediatric Follow-up TRF Intestine Pediatric Wksheet.pdf Form
26 Intestine Follow-up TRF Intestine Adult Wksheet.pdf Form
26c Post 5-Year Intestine Follow-up TRF Post 5-Year All Organs Adult Wksheet.pdf Form
26d Post 5-Year Intestine Pediatric Follow-up TRF Post 5-Year All Organs Pediatric Wksheet.pdf Form
Transplant Recipient Follow-up - Intestine.doc Transplant Recipient Follow-up - Intestine IC Document
Transplant Recipient Follow-up - Intestine - Post 5-Year.doc Transplant Recipient Follow-up - Intestine - Post 5-Year IC Document

Information Collection (IC) Details

IC Title:	OPTN- Intestine 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	26b	Intestine Pediatric Follow-up	TRF Intestine Pediatric Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	26	Intestine Follow-up	TRF Intestine Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	26c	Post 5-Year Intestine Follow-up	TRF Post 5-Year All Organs Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	26d	Post 5-Year Intestine 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: 44	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	1,232	467	765
Annual IC Time Burden (Hours)	1,047	660	387
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Transplant Recipient Follow-up - Intestine	Transplant Recipient Follow-up - Intestine.doc	09/14/2010
Transplant Recipient Follow-up - Intestine - Post 5-Year	Transplant Recipient Follow-up - Intestine - Post 5-Year.doc	09/14/2010

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