DAFORMFILLABLE.COM | DA FORM 5440-53 Fillable – Army Pubs 5440-53 PDF – DA FORM 5440-53, titled Delineation Of Clinical Privileges – Occupational Medicine, is a critical document used within the Army medical system to outline the specific clinical privileges granted to healthcare professionals in the field of occupational medicine. This form is essential for ensuring that medical personnel are properly credentialed to perform their duties, thereby safeguarding the health and safety of military personnel.
DA FORM 5440-53 – Delineation Of Clinical Privileges – Occupational Medicine
| Form Number | DA Form 5440-53 |
| Form Title | Delineation Of Clinical Privileges – Occupational Medicine |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5440-53
Publication Details
- Pub/Form Number: DA FORM 5440-53
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Delineation Of Clinical Privileges – Occupational Medicine
- Pub/Form Proponent: TSG
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 40-68
- Security Classification: UNCLASSIFIED
- Distribution Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 081325
This form is produced exclusively in electronic media and includes a Privacy Act Statement as mandated by AR 340-21.
Importance of Clinical Privileges in Occupational Medicine
What Are Clinical Privileges?
Clinical privileges refer to the specific medical procedures and treatments that a healthcare provider is authorized to perform. These privileges are granted based on the provider’s credentials, training, experience, and demonstrated competence.
Role of Occupational Medicine
Occupational medicine is a branch of medicine that focuses on the health and safety of workers, including the prevention and treatment of diseases and injuries related to the workplace. For military personnel, this field is crucial as it addresses the unique health risks associated with military occupations.
Completing DA FORM 5440-53
Key Sections of the Form
- Provider Information: This section includes the healthcare provider’s name, rank, and contact information.
- Clinical Privileges Requested: A detailed list of the specific procedures and treatments the provider seeks to be authorized to perform.
- Qualifications and Training: Documentation of the provider’s medical education, training, and any certifications relevant to occupational medicine.
- Approval and Signatures: This section requires the signatures of the approving authority and the healthcare provider, signifying the granting of the requested clinical privileges.
Submission and Approval Process
The completed form must be submitted to the appropriate medical command authority for review. The approval process involves a thorough evaluation of the provider’s qualifications and the needs of the medical facility. Once approved, the provider is granted the delineated clinical privileges, allowing them to perform specific medical procedures within the scope of occupational medicine.
Regulatory and Compliance Aspects
AR 40-68
The prescribing directive for DA FORM 5440-53 is AR 40-68. This regulation outlines the policies and procedures for granting clinical privileges to healthcare providers within the Army medical system. Compliance with AR 40-68 ensures that all providers meet the required standards for delivering high-quality medical care.
Privacy Act Statement
As required by AR 340-21, DA FORM 5440-53 includes a Privacy Act Statement. This statement ensures that the personal information of healthcare providers is protected in accordance with federal privacy laws.
Conclusion
DA FORM 5440-53 – Delineation Of Clinical Privileges – Occupational Medicine is a vital tool in the Army medical system. It ensures that healthcare providers are properly credentialed to deliver specialized medical care in occupational medicine. By adhering to the guidelines set forth in AR 40-68 and protecting personal information as required by AR 340-21, the form upholds the standards of quality and security in military healthcare.
For those involved in military medical services, understanding and correctly utilizing DA FORM 5440-53 is essential for maintaining a high standard of occupational health and safety for military personnel.
DA FORM 5440-53 Fillable – Army Pubs 5440-53 PDF DOWNLOAD
