DAFORMFILLABLE.COM | DA FORM 5441-20 Fillable – Army Pubs 5441-20 PDF – DA FORM 5441-20, titled Evaluation of Clinical Privileges – Occupational Therapy, is a crucial document in the realm of military healthcare. This form is used to assess and validate the clinical privileges of occupational therapists within the Army. Here’s an in-depth look into this essential form, its purpose, and how it is used.
DA FORM 5441-20 – Evaluation Of Clinical Privileges – Occupational Therapy
| Form Number | DA Form 5441-20 |
| Form Title | Evaluation Of Clinical Privileges – Occupational Therapy |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5441-20
DA FORM 5441-20 is a standardized form published on February 1, 2004, by The Surgeon General (TSG). It is currently in active status and is used across military medical facilities to ensure occupational therapists meet the required standards to perform their duties.
Key Information:
- Pub/Form Number: DA FORM 5441-20
- Pub/Form Date: 02/01/2004
- Pub/Form Proponent: TSG (The Surgeon General)
- Pub/Form Status: Active
- 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: 066550
Purpose of DA FORM 5441-20
The primary purpose of DA FORM 5441-20 is to evaluate the clinical privileges of occupational therapists within the Army. It ensures that therapists are competent and qualified to provide therapeutic services to soldiers and other beneficiaries. This evaluation is part of maintaining high standards in military healthcare and ensuring the safety and well-being of patients.
Structure and Components of DA FORM 5441-20
The form includes several key sections designed to comprehensively assess an occupational therapist’s qualifications and performance. These sections typically include:
Personal Information
- Name of the Therapist
- Rank/Grade
- Social Security Number (SSN)
Clinical Privileges
- List of Requested Privileges
- Current Competency in Each Privilege
- Supervisor’s Evaluation and Comments
Performance Evaluation
- Evaluation Period
- Performance Ratings (e.g., satisfactory, needs improvement)
- Additional Comments and Recommendations
Certification
- Signatures of the Evaluating Officer
- Date of Evaluation
Compliance and Privacy Considerations
This form must comply with the Privacy Act Statement (AR 340-21), ensuring that all personal information is protected and used appropriately. Additionally, as it is produced in electronic media, it facilitates easier distribution and accessibility.
Importance of DA FORM 5441-20 in Occupational Therapy
The DA FORM 5441-20 plays a critical role in maintaining the standards of occupational therapy within the Army. By evaluating therapists’ clinical privileges, it ensures that only qualified professionals provide care. This process helps to uphold the integrity and quality of healthcare services provided to military personnel.
Accessing and Submitting DA FORM 5441-20
This form is available electronically, making it accessible for all relevant personnel. Once completed, it must be submitted through the appropriate channels for review and certification. The unlimited distribution restriction code indicates that it can be freely distributed, ensuring that all necessary parties can access and use the form without restrictions.
Conclusion
The DA FORM 5441-20 – Evaluation of Clinical Privileges – Occupational Therapy is an indispensable tool in the military healthcare system. It ensures that occupational therapists are thoroughly evaluated and deemed competent to perform their duties, ultimately contributing to the high standards of care within the Army. Understanding and properly utilizing this form is crucial for maintaining the effectiveness and safety of therapeutic services provided to military personnel.
By adhering to these evaluation processes, the Army ensures that its occupational therapists are well-qualified, maintaining the trust and health of those who serve.
DA FORM 5441-20 Fillable – Army Pubs 5441-20 PDF DOWNLOAD
