Heart/Lung Transplant Recipient Follow Up Post 5 Year (TRF)

Data System for Organ Procurement and Transplantation Network

OMB: 0915-0157

IC ID: 214128

Information Collection (IC) Details

View Information Collection (IC)

Heart/Lung Transplant Recipient Follow Up Post 5 Year (TRF)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction HeartLung Transplant Recipient Follow Up Post 5 Year_Instructions.docx Yes Yes Fillable Fileable
Form 22 Heart/Lung Transplant Recipient Follow Up Post 5 Year_Form.xlsx HeartLung Transplant Recipient Follow Up Post 5 Year_Form.xlsx Yes Yes Fillable Fileable

Health Public Health Monitoring

Privacy Act System of Records Notice #09-15-0055  87 FR 46967

70 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 235 0 7 0 0 228
Annual IC Time Burden (Hours) 141 0 4 0 0 137
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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