Organ Procurement and Transplantation Network Application Form

OMB 0915-0184

OMB 0915-0184

This is a request for OMB approval for revisions of the application documents used to collect information for determining if the interested party is compliant with membership requirements contained in the final rule Governing the Operation of the Organ Procurement and Transplantation Network (OPTN), (42 CFR part 121) ‘‘the OPTN final rule.’’ Respondents include: hospitals seeking to perform organ transplants, non-profit organizations seeking to become an organ procurement organization, and medical laboratories seeking to become an OPTN-approved histocompatibility laboratory.

The latest form for Organ Procurement and Transplantation Network Application Form expires 2023-08-31 and can be found here.

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OPTN Membership Application for Transplant Hospitals

Federal Enterprise Architecture: Health - Health Care Services

Form 1Membership_Transplant Hospital_General Form.docx Fillable FileableForm and instruction

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