OPTN- Kidney/Pancreas 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⚠️ Notice: This information collection may be referencing outdated material.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-Pancreas Post 5 Year Transplant Recipient Follow Up Instructions.pdf Instruction
Kidney-Pancreas Transplant Recipient Follow Up Instructions.pdf Instruction
20 Kidney-Pancreas Adult Post 5 Year Transplant Recipient F Kidney-Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf Form
20b Kidney-Pancreas Adult Transplant Recipient Follow Up Wor Kidney-Pancreas Adult Transplant Recipient Follow Up Worksheet.pdf Form
20c Kidney-Pancreas Pediatric Post 5 Year Transplant Recipie Kidney-Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Workshseet.pdf Form
20d Kidney-Pancreas Pediatric Transplant Recipient Follow Up Kidney-Pancreas_Pediatric_Transplant_Recipient_Follow_Up_Worksheet[1].pdf Form

Information Collection (IC) Details

IC Title:	OPTN- Kidney/Pancreas Follow-up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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-Pancreas Post 5 Year Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Instruction			Kidney-Pancreas Transplant Recipient Follow Up Instructions.pdf	Yes	No	Printable Only
Form	20	Kidney-Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet	Kidney-Pancreas Adult Post 5 Year Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	20b	Kidney-Pancreas Adult Transplant Recipient Follow Up Worksheet	Kidney-Pancreas Adult Transplant Recipient Follow Up Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	20c	Kidney-Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Workshseet	Kidney-Pancreas Pediatric Post 5 Year Transplant Recipient Follow Up Workshseet.pdf	Yes	Yes	Fillable Fileable
Form	20d	Kidney-Pancreas Pediatric Transplant Recipient Follow Up Worksheet	Kidney-Pancreas_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: 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 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-10,800	10,800
Annual IC Time Burden (Hours)	-9,180	9,180
Annual IC Cost Burden (Dollars)	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.