Information Collection

National Survey of Organ Donation Attitudes and Practices

IC 6543 under ICR 201112-0915-001 · OMB 0915-0290.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0290 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 National Survey of Organ Donation Attitudes and Practices	Form and Instruction
1 Revised Survey Survey with OMB changes (face+hands, new ethnicity categories) 02-28-12.doc	Form and Instruction

IC Title:

National Survey of Organ Donation Attitudes and Practices

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Revised Survey	Survey with OMB changes (face+hands, new ethnicity categories) 02-28-12.doc		No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,250	3,250
Annual IC Time Burden (Hours)	975	975
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.