DAFORMFILLABLE.COM | DA FORM 5440-21 Fillable – Army Pubs 5440-21 PDF – DA FORM 5440-21, titled Delineation Of Clinical Privileges-Physical Therapy, is a critical document used in the United States Army to outline the specific clinical privileges granted to physical therapists. This form ensures that physical therapists within the military are authorized to perform specific clinical tasks, providing clarity and maintaining high standards of care.
DA FORM 5440-21 – Delineation Of Clinical Privileges-Physical Therapy
| Form Number | DA Form 5440-21 |
| Form Title | Delineation Of Clinical Privileges-Physical Therapy |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5440-21
Pub/Form Number: DA FORM 5440-21
Pub/Form Date: 02/01/2004
Pub/Form Title: Delineation Of Clinical Privileges-Physical Therapy
Pub/Form Proponent: TSG (The Surgeon General)
Pub/Form Status: ACTIVE
Prescribed Forms/Prescribing Directive: AR 40-68
Footnotes:
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
Authority: Superseded By/Rescinded By
Superseded/Replaced Other Pub/Form: None
Security Classification: UNCLASSIFIED
Dist Restriction Code: A APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED
Pub/Form IDN: 990001
Pub/Form PIN: 066510
Changes: None
Purpose and Importance
The primary purpose of DA FORM 5440-21 is to clearly define the clinical privileges granted to physical therapists within the Army. This form is essential for maintaining high standards of patient care and ensuring that all physical therapy services are provided by qualified professionals.
Structure and Content
The form includes several sections that detail the specific privileges and responsibilities of the physical therapist. These sections typically include:
- Identification Information: This section captures the basic details of the therapist, such as name, rank, and service number.
- Clinical Privileges: Detailed listing of all procedures and treatments the therapist is authorized to perform.
- Competency Assessment: Evaluation of the therapist’s skills and competencies in various physical therapy techniques.
- Approval and Signatures: This section includes the signatures of the approving authority, ensuring that the therapist’s privileges are officially recognized.
Compliance and Privacy
DA FORM 5440-21 requires compliance with AR 40-68 and includes a Privacy Act Statement as per AR 340-21. This ensures that all personal information is handled according to privacy regulations, maintaining confidentiality and protecting the therapist’s data.
Usage and Distribution
The form is classified as UNCLASSIFIED and has a distribution restriction code of A, meaning it is approved for public release and can be distributed without limitations. This wide distribution is crucial for transparency and accessibility within the military medical community.
Key Takeaways
- Delineation of Privileges: The form explicitly outlines what clinical tasks a physical therapist is authorized to perform, ensuring clarity and precision in their professional duties.
- Maintaining Standards: By clearly defining clinical privileges, DA FORM 5440-21 helps maintain high standards of care within the military.
- Regulatory Compliance: The form ensures compliance with relevant regulations, including AR 40-68 and AR 340-21.
- Public Accessibility: Being approved for public release, the form is readily accessible, promoting transparency within the military healthcare system.
Conclusion
DA FORM 5440-21 is an essential document for the delineation of clinical privileges for physical therapists in the U.S. Army. It plays a vital role in ensuring that only qualified professionals provide physical therapy services, thereby maintaining high standards of patient care. Understanding the structure, purpose, and regulatory compliance associated with this form is crucial for all military healthcare providers and administrators.
By incorporating relevant keywords such as clinical privileges, physical therapy, Army regulations, and patient care standards, this article is designed to be SEO-friendly and informative for individuals seeking comprehensive information about DA FORM 5440-21.
DA FORM 5440-21 Fillable – Army Pubs 5440-21 PDF DOWNLOAD
