DAFORMFILLABLE.COM | DA FORM 5441-42 Fillable – Army Pubs 5441-42 PDF – DA FORM 5441-42, officially titled Evaluation of Clinical Privileges – Cardiology, is a crucial document used by the United States Army to assess the clinical privileges of cardiology professionals. This form, published on 02/01/2004, ensures that cardiologists meet the required standards to perform their duties effectively and safely.
DA FORM 5441-42 – Evaluation Of Clinical Privileges – Cardiology
| Form Number | DA Form 5441-42 |
| Form Title | Evaluation Of Clinical Privileges – Cardiology |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance of DA FORM 5441-42
The primary purpose of DA FORM 5441-42 is to evaluate the qualifications and competencies of cardiologists. This evaluation is essential to maintain high standards of medical care within the military health system. The form is mandated by AR 40-68, which outlines the requirements for clinical privileges and credentialing within the Army.
Key Components of DA FORM 5441-42
Personal Information and Credentials
The form begins with sections for personal information, including the cardiologist’s name, rank, and contact details. It also requires documentation of their medical education, training, and certification. This information is vital for verifying the individual’s background and qualifications.
Clinical Privileges Evaluation
The core of DA FORM 5441-42 focuses on the evaluation of clinical privileges. This section is divided into various procedures and competencies specific to cardiology. Evaluators must assess the cardiologist’s proficiency in each area, marking whether they are qualified to perform these tasks independently or under supervision.
Performance and Competency Assessment
Evaluators provide a detailed performance and competency assessment, highlighting the cardiologist’s strengths and areas for improvement. This part of the form ensures that only those who meet the high standards of military medical practice are granted full clinical privileges.
Privacy and Security
DA FORM 5441-42 requires adherence to the Privacy Act Statement (AR 340-21), ensuring that all personal and professional information is handled with the utmost confidentiality. The form is unclassified and approved for public release, with unlimited distribution.
Electronic Format and Accessibility
This form is produced only in electronic media (Pub/Form Status: ACTIVE), making it easily accessible for military medical personnel. The digital format ensures that the form can be efficiently distributed and filled out, streamlining the evaluation process.
Utilizing DA FORM 5441-42 in Professional Activities
For those in the field of cardiology within the Army, understanding and properly utilizing DA FORM 5441-42 is essential. The form not only validates clinical privileges but also plays a significant role in maintaining the quality and integrity of medical services provided to service members.
Steps to Complete DA FORM 5441-42
- Gather Required Information: Ensure all personal, educational, and professional details are accurate and up-to-date.
- Understand Evaluation Criteria: Familiarize yourself with the specific competencies and procedures listed on the form.
- Conduct Self-Assessment: Reflect on your own skills and areas for improvement before undergoing the formal evaluation.
- Submit for Evaluation: Provide the completed form to the designated evaluator or credentialing authority within your medical facility.
Conclusion
DA FORM 5441-42 – Evaluation of Clinical Privileges – Cardiology is a vital tool for ensuring the competency and qualifications of cardiologists in the U.S. Army. By adhering to the evaluation criteria and maintaining high standards of medical practice, military cardiologists can provide the best possible care to their patients.
Understanding the form’s structure, purpose, and requirements is crucial for those involved in military medical services, ensuring that all personnel meet the necessary standards for clinical privileges. For more detailed information, individuals can refer to the prescribing directive, AR 40-68, and the form’s electronic media instructions.
By following these guidelines and utilizing DA FORM 5441-42 effectively, the Army ensures that its medical professionals are well-equipped to handle the challenges of their roles, ultimately contributing to the overall health and readiness of the force.
DA FORM 5441-42 Fillable – Army Pubs 5441-42 PDF DOWNLOAD
