OPTN- Kidney 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⚠️ Notice: This information collection may be referencing outdated material.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
Kidney Post 5 Year Transplant Recipient Follow Up Instructions.pdf Instruction
Kidney Transplant Recipient Follow Up Instructions.pdf Instruction
14 Kidney Adult Post 5 year Transplant Recipient Follow Up Kidney Adult Post 5 YearTransplant Recipient Follow Up Worksheet.pdf Form
14b Kidney Adult Transplant Recipient Follow Up Worksheet Kidney Adult Transplant Recipient Follow Up Worksheet.pdf Form
14c Kidney Pediatric Post 5 Year Transplant Recipient Follow Kidney_Pediatric_Post_5_Year_Transplant_Recipient_Follow_Up_Worksheet[1].pdf Form
14d Kidney Pediatric Transplant Recipient Follow Up Workshee Kidney_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf Form

Information Collection (IC) Details

IC Title:	OPTN- Kidney 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
Instruction			Kidney Post 5 Year Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Instruction			Kidney Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Form	14	Kidney Adult Post 5 year Transplant Recipient Follow Up worksheet	Kidney Adult Post 5 YearTransplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	14b	Kidney Adult Transplant Recipient Follow Up Worksheet	Kidney Adult Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	14c	Kidney Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet	Kidney_Pediatric_Post_5_Year_Transplant_Recipient_Follow_Up_Worksheet[1].pdf	Yes	Yes	Fillable Fileable
Form	14d	Kidney Pediatric Transplant Recipient Follow Up Worksheet	Kidney_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 239	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	165,627	-13,195	178,822
Annual IC Time Burden (Hours)	91,095	-7,257	98,352
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.