Scientific Registry of Transplant Recipients Information Collection Effort for Potential Donors for Living Organ Donation

Scientific Registry of Transplant Recipients Information Collection Effort for Potential Donors for Living Organ Donation (SRTR)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0034 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Scientific Registry of Transplant Recipients Information Collection Effort for Potential Donors for Living Organ Donation Form
2 SRTR Candidate Reasons Did Not Donate_Liver and Kidney F SRTR Candidate Reasons Did Not Donate_Liver and Kidney Form_10-11-17.docx Form
3 SRTR Form Potential Living Donor Follow-up Form_1 yr_10- SRTR Form Potential Living Donor Follow-up Form_1 yr_10-11-17.docx Form
1 SRTR Initial Registration Worksheet_20171208_updates.doc SRTR Initial Registration Worksheet_20171208_updates.docx Form

Information Collection (IC) Details

IC Title:	Scientific Registry of Transplant Recipients Information Collection Effort for Potential Donors for Living Organ Donation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2	SRTR Candidate Reasons Did Not Donate_Liver and Kidney Form_10-11-17.docx	SRTR Candidate Reasons Did Not Donate_Liver and Kidney Form_10-11-17.docx	Yes	Yes	Fillable Fileable
Form	3	SRTR Form Potential Living Donor Follow-up Form_1 yr_10-11-17.docx	SRTR Form Potential Living Donor Follow-up Form_1 yr_10-11-17.docx	Yes	Yes	Fillable Fileable
Form	1	SRTR Initial Registration Worksheet_20171208_updates.docx	SRTR Initial Registration Worksheet_20171208_updates.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 804	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	804	804
Annual IC Time Burden (Hours)	1,358	1,358
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.