Information Collection

OPTN- Pancreas Follow-up

IC 181747 under ICR 201202-0915-001 · OMB 0915-0157.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pancreas Post 5 Year Transplant Recipient Follow Up Instructions.pdf	Instruction
Pancreas Transplant Recipient Follow Up Instructions.pdf	Instruction
23 Pancreas Adult Post 5 Year Transplant Recipient Follow U Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Form
23b Pancreas Adult Transplant Recipient Follow Up Worksheet Pancreas Adult Transplant Recipient Follow Up Worksheet.pdf	Form
23c Pancreas Pediatric Post 5 Year Transplant Recipient Foll Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Form
23d Pancreas Pediatric Transplant Recipient Follow Up Worksh Pancreas Pediatric Transplant Recipient Follow Up Worksheet.pdf	Form

IC Title:

OPTN- Pancreas Follow-up

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Pancreas Post 5 Year Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Instruction			Pancreas Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Form	23	Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet	Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	23b	Pancreas Adult Transplant Recipient Follow Up Worksheet	Pancreas Adult Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	23c	Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet	Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	23d	Pancreas Pediatric Transplant Recipient Follow Up Worksheet	Pancreas Pediatric Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 144

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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,312	452	2,860
Annual IC Time Burden (Hours)	2,153	294	1,859
Annual IC Cost Burden (Dollars)	0	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.