Heart, Lung, Heart/Lung Follow Up (1-5 year)

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⚠️ Notice: This information collection may be referencing outdated material.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 21 Heart, Lung, Heart/Lung Follow Up (1-5 year) Form and Instruction
21 Heart, Lung, Heart/Lung Follow Up (1-5 year) 21 Thoracic Transplant Recipient Follow_Heart_Lung_HL_Instructions.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Heart, Lung, Heart/Lung Follow Up (1-5 year)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	21	Heart, Lung, Heart/Lung Follow Up (1-5 year)	21 Thoracic Transplant Recipient Follow_Heart_Lung_HL_Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 259	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16,139	16,139
Annual IC Time Burden (Hours)	17,753	17,753
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.