DAFORMFILLABLE.COM | DA FORM 5441-6 Fillable – Army Pubs 5441-6 PDF – DA FORM 5441-6, officially titled “Evaluation Of Clinical Privileges-Optometry,” is a critical document utilized within the military healthcare system. This form, which has been in active use since February 1, 2004, is governed by the Army Regulation (AR) 40-68. The primary purpose of this form is to assess and document the clinical privileges of optometrists serving within military facilities. The form is electronically produced, emphasizing the importance of digital records in modern military operations.
DA FORM 5441-6 – Evaluation Of Clinical Privileges-Optometry
| Form Number | DA Form 5441-6 |
| Form Title | Evaluation Of Clinical Privileges-Optometry |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance
Ensuring Quality Care
The DA FORM 5441-6 plays a vital role in ensuring that only qualified optometrists are granted clinical privileges. By rigorously evaluating the competencies of optometry professionals, the military ensures high standards of optometric care for its personnel. This evaluation process is essential for maintaining trust and reliability within military healthcare services.
Compliance and Regulation
The form is prescribed by AR 40-68, which outlines the standards for credentialing and privileging within the Army Medical Department. Compliance with these regulations is mandatory, ensuring that all evaluations are conducted uniformly and transparently. The form’s active status signifies its ongoing relevance and necessity in military healthcare operations.
Key Components of DA FORM 5441-6
Privacy and Security
The form includes specific footnotes that highlight the need for a Privacy Act Statement (AR 340-21). This ensures that all personal and professional information documented on the form is handled with the utmost confidentiality. Additionally, the form is classified as UNCLASSIFIED but is approved for public release, meaning it can be distributed without restriction.
Digital Accessibility
Produced exclusively in electronic media, the form aligns with the military’s shift towards digital record-keeping. This not only enhances accessibility but also ensures that records are easily updated and maintained. The form’s Pub/Form IDN (990001) and Pub/Form PIN (066537) provide unique identifiers for precise referencing and retrieval within the military’s documentation systems.
Evaluation Process
Criteria for Evaluation
The evaluation process outlined in DA FORM 5441-6 involves a comprehensive review of an optometrist’s clinical skills, professional conduct, and overall competency. Specific criteria include the ability to perform routine eye exams, diagnose and manage ocular diseases, and provide pre- and post-operative care for ocular surgeries.
Review and Approval
Evaluations are conducted by qualified senior medical personnel who are well-versed in optometric standards and practices. The completed form is then reviewed and approved by higher authorities to ensure that the optometrist meets all necessary qualifications for clinical privileges.
Distribution and Use
Broad Distribution
The distribution code A indicates that the form is approved for public release and can be distributed without limitation. This broad distribution capability ensures that all relevant military healthcare facilities and personnel have access to the form, facilitating a standardized evaluation process across the board.
Practical Application
In practical terms, the DA FORM 5441-6 is used during the initial granting of clinical privileges, as well as during periodic re-evaluations. This ongoing review process helps in maintaining a high standard of care and adapting to any changes in clinical guidelines or personnel performance.
Conclusion
The DA FORM 5441-6 – Evaluation Of Clinical Privileges-Optometry is a cornerstone in maintaining the quality and reliability of optometric care within the military. By adhering to the stringent evaluation criteria set forth in AR 40-68 and ensuring compliance with privacy and security standards, this form ensures that only the most qualified optometrists are granted clinical privileges. Its electronic format enhances accessibility and efficiency, making it an indispensable tool in military healthcare.
By understanding and utilizing DA FORM 5441-6, military healthcare providers can continue to deliver exceptional care to their service members, ensuring that their vision health is in capable hands.
DA FORM 5441-6 Fillable – Army Pubs 5441-6 PDF DOWNLOAD
