DAFORMFILLABLE.COM | DA FORM 5441-35 Fillable – Army Pubs 5441-35 PDF – DA FORM 5441-35 is a crucial document within the military healthcare system, specifically designed for the evaluation of clinical privileges for psychological associates. This form plays an essential role in ensuring that psychological associates meet the necessary standards to provide quality care. This article will provide a comprehensive overview of DA FORM 5441-35, its purpose, and the key aspects associated with its use.
DA FORM 5441-35 – Evaluation Of Clinical Privileges – Psychological Associate
| Form Number | DA Form 5441-35 |
| Form Title | Evaluation Of Clinical Privileges – Psychological Associate |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5441-35
DA FORM 5441-35, titled Evaluation of Clinical Privileges – Psychological Associate, was established on February 1, 2004. This form is issued by the Office of The Surgeon General (TSG) and remains in active status. The form is mandated by AR 40-68, which governs the clinical privileges within the Army Medical Department.
Purpose of DA FORM 5441-35
The primary purpose of DA FORM 5441-35 is to evaluate the qualifications and performance of psychological associates who are seeking clinical privileges. The evaluation process ensures that these professionals possess the necessary skills, knowledge, and competencies to perform their duties effectively within the military healthcare system.
Key Features and Requirements
Privacy Act Statement
One of the critical footnotes associated with DA FORM 5441-35 is the requirement for a Privacy Act Statement, as stipulated by AR 340-21. This ensures that all personal information collected through the form is handled in accordance with privacy regulations, protecting the confidentiality of the individuals being evaluated.
Electronic Media
DA FORM 5441-35 is produced only in electronic media, making it easily accessible and distributable within the military healthcare system. This electronic format supports efficient processing and record-keeping.
Public Release
The form is classified as UNCLASSIFIED and is approved for public release. There are no distribution restrictions, meaning the form can be freely distributed and accessed by authorized personnel.
Utilization and Process
Submission and Review
Psychological associates seeking clinical privileges must complete DA FORM 5441-35. The completed form is then submitted to the appropriate review board or committee responsible for evaluating the applicant’s qualifications and performance.
Evaluation Criteria
The evaluation process includes a thorough review of the psychological associate’s education, training, experience, and professional conduct. Evaluators use the information provided on DA FORM 5441-35 to determine whether the applicant meets the required standards for clinical privileges.
Approval and Documentation
Once the evaluation is complete, the review board makes a decision regarding the granting of clinical privileges. Approved privileges are documented, and the completed DA FORM 5441-35 is kept on file for future reference and re-evaluation.
Importance of DA FORM 5441-35
The DA FORM 5441-35 is vital for maintaining high standards of care within the military healthcare system. By thoroughly evaluating psychological associates, the form ensures that only qualified professionals are granted clinical privileges, thereby protecting the well-being of military personnel and their families.
Conclusion
In summary, DA FORM 5441-35 – Evaluation of Clinical Privileges – Psychological Associate is a critical tool in the military healthcare system, ensuring that psychological associates meet stringent standards before being granted clinical privileges. The form’s comprehensive evaluation process, combined with strict privacy and distribution regulations, supports the delivery of high-quality psychological care. For more detailed information on the form and its requirements, refer to AR 40-68 and the associated privacy act statements.
DA FORM 5441-35 Fillable – Army Pubs 5441-35 PDF DOWNLOAD
