Names Crosswalk

Names_Crosswalk.xlsx

Organ Procurement and Transplantation Network Application Form

Names Crosswalk

OMB: 0915-0184

Document [xlsx]
Download: xlsx | pdf
Current Cycle File: Expiring 7/31/2020 New Names Notes
A1_NewTransplantHospital_Cover Membership_TransplantHospital_General Form
A2_NewTransplant_General
B1_NewTransplantProgram_Cover_Clean_HRSA N/A No longer needed. Information is captured in new Kidney, Liver, Pancreas, Pancreas Islet, Heart, Lung and Intestine
B3_Kidney_LDKidney Membership_Kidney_LDKidney Form
B4_Liver_LDLiver Membership_Liver_LDLiver Form
B5_Pancreas Membership_Pancreas Form
B6_Heart Membership_Heart Form
B7_Lung Membership_Lung Form
B8_PancreasIslet Membership_PancreasIslet Form
B9_NewLiving Donor Recoveries N/A No longer needed. Information is captured in new Kidney and Liver Applications

C_OPO_New Membership_OPO Form New Form will serve as new program and key personnel change request
G_OPO_DirectorChange
D_HistoLab_New Membership_HistoLab Form New Form will serve as new program and key personnel change request
F_HistoLab_PersonnelChange
E_PersonnelChange_Cover N/A No longer needed: Members will use relevant portions of their respective organ applications to apply for a key personnel change
H_MedicalScientific Membership_MedicalScientific Form
I_PublicOrg Membership_PublicOrg Form
J_Business Membership_Business Form
K_Individual Membership_Individual Form
L_Intestine Membership_Intestine Form
M1_VCA_NewTransplantProgram

M2_VCA_AW_Intestine

M3_VCA_AW_Kidney

M4_VCA_AW_Liver

M5_VCA_AW_Pancreas

M6_VCA_Head and Neck Membership_VCA Form All requests for VCA have been combined into one form
M7_VCA_Upper Limb

N1_VCA_Other_NewTransplantProgram

N2_VCA_Other_PersonnelChange_Cover

N3_VCA_Other

O_VCA_PersonnelChange_Cover


Membership_SurgeonOrPhysicianLog Form New Independent Form. Information was previously collected within organ application. This form will accompany every application and must be filled out as part of membership application

Membership_CertificateAssessment_ProgramCoverage Form New Independent Form. Information was previously collected within organ application. This form will accompany every application and must be filled out as part of membership application

Membership_Representative Form New Form. Information is routinely collected from member
Total Files = 30 Total Files = 18
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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