Organ Procurement and Transplantation Network Application

Organ Procurement and Transplantation Network Application Form

OMB: 0915-0184

IC ID: 6410

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Organ Procurement and Transplantation Network Application
 
No Removed
 
Required to Obtain or Retain Benefits
 
42 CFR 121

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction B5 B5 B5_Pancreas.doc Yes Yes Fillable Printable
Form and Instruction B6 B6 B6_Heart.doc Yes Yes Fillable Printable
Form and Instruction B7 B7 B7_Lung.doc Yes Yes Fillable Printable
Form and Instruction B8 B8 B8_PancreasIslet.doc Yes Yes Fillable Printable
Form and Instruction B9 B9 B9_LivingDonorRecoveries.doc Yes Yes Fillable Printable
Form and Instruction A2 A2 A2_NewTransplantHospital_General.doc Yes Yes Fillable Printable
Form and Instruction B3 B3 B3_Kidney_LDKidney.doc Yes Yes Fillable Printable
Form and Instruction B4 B4 B4_Liver_LDLiver.doc Yes Yes Fillable Printable
Form and Instruction D Histocompatibility Laboratory Membership Application D_HistoLab.doc Yes Yes Fillable Printable
Form and Instruction C Application for Organ Procurement (OPO) Membership C_OPO.doc Yes Yes Fillable Printable
Form and Instruction A1 A1 A1_NewTransplantHospital_Cover.doc Yes Yes Fillable Printable
Form and Instruction B1 B1 B1_NewTransplantProgram_Cover.doc Yes Yes Fillable Printable

Health Public Health Monitoring

 

376 0
   
Private Sector Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -744 0 0 744
Annual IC Time Burden (Hours) 0 0 -2,908 0 0 2,908
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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