DAFORMFILLABLE.COM | DA FORM 5440-44 Fillable – Army Pubs 5440-44 PDF – DA FORM 5440-44 is an essential document in the medical field, specifically within otolaryngology. This form outlines the clinical privileges granted to medical professionals in this specialty, ensuring that only qualified individuals perform specific medical procedures. Below, we will delve into the details of DA FORM 5440-44, its purpose, and its application.
DA FORM 5440-44 – Delineation Of Clinical Privileges – Otolaryngology
| Form Number | DA Form 5440-44 |
| Form Title | Delineation Of Clinical Privileges – Otolaryngology |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
What is DA FORM 5440-44?
DA FORM 5440-44, titled “Delineation Of Clinical Privileges – Otolaryngology”, is a formal document used by the U.S. Army to specify and authorize the range of clinical activities that an otolaryngologist is permitted to perform. This form is vital for maintaining high standards of care and ensuring patient safety.
Key Details of DA FORM 5440-44
- Publication Number: DA FORM 5440-44
- Publication Date: February 1, 2004
- Proponent: The Surgeon General (TSG)
- Status: Active
- Prescribing Directive: AR 40-68
- Security Classification: Unclassified
- Distribution Restriction Code: Approved for public release; distribution is unlimited
- Form IDN: 990001
- Form PIN: 081316
Importance of DA FORM 5440-44
The DA FORM 5440-44 plays a crucial role in the medical field by delineating the specific clinical privileges of otolaryngologists. This ensures that medical professionals operate within their scope of competence, which is fundamental for patient safety and the quality of care provided.
Ensuring Qualified Medical Practice
By clearly defining what procedures and treatments an otolaryngologist can perform, the form helps to prevent unauthorized practice and ensures that patients receive care from adequately trained and certified professionals.
Compliance with Regulations
The form is prescribed by AR 40-68, a directive that governs the credentialing and privileging of healthcare providers within the Army. Adherence to these regulations is mandatory, and DA FORM 5440-44 is a key component of this compliance.
Structure and Content of DA FORM 5440-44
The form includes several sections where specific privileges are listed and granted. These sections are meticulously filled out to reflect the competencies of the medical professional.
Sections of DA FORM 5440-44
- Personal Information: This section includes the name, rank, and identification details of the otolaryngologist.
- Professional Qualifications: Details regarding the medical training, certifications, and experience of the professional.
- Clinical Privileges: A comprehensive list of the clinical procedures and treatments that the otolaryngologist is authorized to perform.
- Approval and Signatures: The form requires signatures from authorized personnel, including supervisors and credentialing officers, to validate the privileges.
Privacy and Security
According to footnote 14, the form requires a Privacy Act Statement (AR 340-21) to ensure that all personal information is handled with confidentiality. Additionally, the form is only produced in electronic media as specified by footnote 42.
Unclassified Status
The unclassified status of DA FORM 5440-44 means that the form does not contain sensitive information that could compromise national security. This allows for unlimited distribution and easy access for authorized personnel.
Conclusion
DA FORM 5440-44 – Delineation Of Clinical Privileges – Otolaryngology is a vital document that ensures the proper authorization of clinical activities within the otolaryngology specialty. By outlining specific privileges, the form helps maintain high standards of medical practice and compliance with Army regulations. Understanding the importance and structure of this form is crucial for medical professionals and administrative staff involved in the credentialing process.
DA FORM 5440-44 Fillable – Army Pubs 5440-44 PDF DOWNLOAD
