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⚠️ Notice: This information collection may be referencing outdated material.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 26c OPTN- Intestine Follow-up Form
Intestine Post 5 Year Transplant Recipient Follow Up Instructions.pdf Instruction
Intestine Transplant Recipient Follow Up Instructions.pdf Instruction
26 Intestine Adult Post 5 Year Transplant Recipient Follow Intestine Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf Form
26b Intestine Adult Transplant Recipient Follow Up Worksheet Intestine Adult Transplant Recipient Follow Up Worksheet.pdf Form
26c Intestine Pediatric Post 5 Year Transplant Recipient Fol Intestine Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf Form
26d Intestine Pediatric Transplant Recipient Follow Up Works Intestine Pediatric Transplant Recipient Follow Up Worksheet.pdf Form

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	26c	Intestine Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet	Intestine Pediatric Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	26d	Intestine Pediatric Transplant Recipient Follow Up Worksheet	Intestine Pediatric Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Instruction			Intestine Post 5 Year Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Instruction			Intestine Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Form	26	Intestine Adult Post 5 Year Transplant Recipient Follow Up Worksheet	Intestine Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	26b	Intestine Adult Transplant Recipient Follow Up Worksheet	Intestine Adult 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: 43	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	1,075	-157	1,232
Annual IC Time Burden (Hours)	914	-133	1,047
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.