DAFORMFILLABLE.COM | DA FORM 5440-43 Fillable – Army Pubs 5440-43 PDF – DA FORM 5440-43, titled Delineation Of Clinical Privileges – Ophthalmology, is a crucial document for medical professionals in the field of ophthalmology. This form, issued by the Department of the Army (DA), outlines the specific clinical privileges granted to ophthalmologists within military medical facilities. The form ensures that healthcare providers have the necessary qualifications and authorizations to perform various ophthalmological procedures.
DA FORM 5440-43 – Delineation Of Clinical Privileges – Ophthalmology
| Form Number | DA Form 5440-43 |
| Form Title | Delineation Of Clinical Privileges – Ophthalmology |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5440-43
Publication Number: DA FORM 5440-43
Publication Date: February 1, 2004
Publication Title: Delineation Of Clinical Privileges – Ophthalmology
Publication Proponent: The Surgeon General (TSG)
Publication Status: Active
Prescribed Forms/Directives: AR 40-68
Footnotes: Requires Privacy Act Statement (AR 340-21), Item only produced in electronic media
Security Classification: Unclassified
Distribution Restriction Code: Approved for public release; distribution is unlimited
Publication IDN: 990001
Publication PIN: 081315
Purpose and Importance
Ensuring Qualified Medical Practice
The primary purpose of DA FORM 5440-43 is to delineate the specific clinical privileges granted to ophthalmologists. This delineation is essential to ensure that only qualified medical professionals perform specific ophthalmological procedures, thereby maintaining high standards of patient care and safety within military medical facilities.
Compliance with Regulations
The form is prescribed by AR 40-68, which governs the medical, dental, and veterinary care policies for the Army. Compliance with this regulation is mandatory, and DA FORM 5440-43 plays a vital role in documenting and verifying the qualifications and privileges of ophthalmologists.
Key Components of DA FORM 5440-43
Clinical Privileges
DA FORM 5440-43 details the various clinical privileges that an ophthalmologist can be granted. These privileges are categorized based on the complexity and nature of the procedures, ranging from basic eye examinations to advanced surgical interventions. Each privilege is granted based on the ophthalmologist’s education, training, and demonstrated competencies.
Privacy and Security
Given the sensitive nature of medical information, DA FORM 5440-43 includes a Privacy Act Statement as required by AR 340-21. This ensures that all personal and professional data collected through this form is handled with the utmost confidentiality and in compliance with privacy regulations.
Electronic Availability
The form is exclusively produced in electronic media, facilitating easier access and distribution. This digital format supports efficient processing and storage of information, ensuring that the latest updates and revisions are readily available to medical personnel.
Implementation and Usage
Process for Granting Privileges
The process of granting clinical privileges using DA FORM 5440-43 involves a thorough review of the ophthalmologist’s credentials, including their educational background, training, certifications, and experience. This review is conducted by a credentialing committee, which then approves the appropriate clinical privileges based on the practitioner’s qualifications.
Maintaining Active Status
The form’s active status indicates that it is currently in use and regularly updated to reflect any changes in policies or regulations. Ophthalmologists must ensure that their delineation of privileges is up to date, as this directly impacts their ability to practice within military medical facilities.
Conclusion
DA FORM 5440-43 – Delineation Of Clinical Privileges – Ophthalmology is an essential document for ensuring the competency and qualifications of ophthalmologists in military healthcare settings. By clearly defining the clinical privileges granted to each practitioner, the form helps maintain high standards of medical care and patient safety. Compliance with the regulations outlined in AR 40-68 and adherence to privacy standards further underscore the form’s importance in the effective management of medical personnel.
Understanding and utilizing DA FORM 5440-43 is crucial for ophthalmologists and administrative personnel involved in the credentialing process, ensuring that only qualified professionals are authorized to perform specialized ophthalmological procedures.
DA FORM 5440-43 Fillable – Army Pubs 5440-43 PDF DOWNLOAD
