Transplant Center Contact Management |
Fields to be completed by members |
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Form Section |
Field Label |
Notes |
Transplant Center Contact Management |
Center |
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Transplant Center Contact Management |
Organ Program |
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Transplant Center Contact Management |
Local Offers Primary |
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Transplant Center Contact Management |
Local Offers Secondary |
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Transplant Center Contact Management |
Import Offers Primary |
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Transplant Center Contact Management |
Import Offers Secondary |
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Transplant Center Contact Management |
Import Offers Set to same as local contacts |
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Transplant Center Contact Management |
Expedited Offers Primary |
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Transplant Center Contact Management |
Expedited Offers Secondary |
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Transplant Center Contact Management |
Expedited Offers Set to same as local contacts |
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Transplant Center Contact Management |
User Type |
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Transplant Center Contact Management |
First Name |
Display only - Cascades from database if User Type is Unet |
Transplant Center Contact Management |
Middle Initial |
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Transplant Center Contact Management |
Last Name |
Display only - Cascades from database if User Type is Unet |
Transplant Center Contact Management |
Institution |
Display only - Cascades from database if User Type is Unet |
Transplant Center Contact Management |
Occupation |
Display only - Cascades from database if User Type is Unet |
Transplant Center Contact Management |
Voice Description |
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Transplant Center Contact Management |
Voice Device Type |
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Transplant Center Contact Management |
Voice Number/E-mail Address |
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Transplant Center Contact Management |
Voice Default |
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Transplant Center Contact Management |
Text Description |
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Transplant Center Contact Management |
Text Device Type |
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Transplant Center Contact Management |
Text Number/E-mail Address |
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Transplant Center Contact Management |
Text Default |
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Transplant Center Contact Management |
Organ Program |
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Transplant Center Contact Management |
Primary |
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Transplant Center Contact Management |
Secondary |
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PUBLIC BURDEN STATEMENT: |
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The private, non-profit Organ Procurement and Transplantation Network (OPTN) collects this information in order to perform the following OPTN functions: to assess whether applicants meet OPTN Bylaw requirements for membership in the OPTN; and to monitor compliance of member organizations with OPTN Obligations. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0915-0157 and it is valid until XX/XX/202X. This information collection is required to obtain or retain a benefit per 42 CFR §121.11(b)(2). All data collected will be subject to Privacy Act protection (Privacy Act System of Records #09-15-0055). Data collected by the private non-profit OPTN also are well protected by a number of the Contractor’s security features. The Contractor’s security system meets or exceeds the requirements as prescribed by OMB Circular A-130, Appendix III, Security of Federal Automated Information Systems, and the Departments Automated Information Systems Security Program Handbook. The public reporting burden for this collection of information is estimated to average 0.27 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected].
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