DAFORMFILLABLE.COM | DA FORM 5441-47 Fillable – Army Pubs 5441-47 PDF – DA FORM 5441-47 is a crucial document within the medical field, particularly for those specializing in preventive medicine. This form plays a vital role in evaluating the clinical privileges of medical professionals, ensuring they meet the necessary standards to provide high-quality preventive healthcare.
DA FORM 5441-47 – Evaluation Of Clinical Privileges – Preventive Medicine
| Form Number | DA Form 5441-47 |
| Form Title | Evaluation Of Clinical Privileges – Preventive Medicine |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5441-47
DA FORM 5441-47, titled Evaluation Of Clinical Privileges – Preventive Medicine, is an active form mandated by the proponent TSG. It was published on February 1, 2004, and remains in active status. This form is crucial for assessing the qualifications and privileges of medical practitioners in the field of preventive medicine.
Purpose and Importance
The primary purpose of DA FORM 5441-47 is to evaluate the clinical privileges of healthcare providers specializing in preventive medicine. This evaluation ensures that medical professionals possess the required competencies and qualifications to deliver preventive healthcare services effectively. By maintaining rigorous standards, the form helps safeguard patient care and uphold medical excellence.
Prescribing Directive
The use of DA FORM 5441-47 is prescribed by AR 40-68, which outlines the policies and procedures for granting and evaluating clinical privileges within the Army Medical Department. This directive ensures that evaluations are conducted systematically and uniformly across the board.
Privacy and Distribution
It is important to note that DA FORM 5441-47 requires a Privacy Act Statement in accordance with AR 340-21. This statement is necessary to inform individuals about the collection and use of personal data, ensuring compliance with privacy regulations.
The form is only produced in electronic media, making it easily accessible and distributable. It is unclassified and approved for public release, with no distribution restrictions. This broad accessibility ensures that all relevant personnel can obtain and use the form as needed.
Key Features
DA FORM 5441-47 includes several key features to facilitate a comprehensive evaluation:
- Personal Information: The form collects essential personal details of the healthcare provider, ensuring accurate identification.
- Qualifications and Competencies: It assesses the provider’s qualifications, training, and competencies in preventive medicine.
- Clinical Performance: The form evaluates the provider’s clinical performance, including their ability to diagnose, treat, and manage preventive healthcare issues.
- Recommendations: Based on the evaluation, the form provides recommendations regarding the granting, modification, or revocation of clinical privileges.
Completing DA FORM 5441-47
Completing DA FORM 5441-47 requires detailed and accurate information. It involves input from both the healthcare provider and the evaluating authority. The process includes:
- Provider Information: The healthcare provider fills out their personal and professional information.
- Competency Assessment: The evaluating authority assesses the provider’s competencies, qualifications, and clinical performance.
- Final Evaluation: The evaluating authority makes a final evaluation and provides recommendations regarding the provider’s clinical privileges.
Conclusion
DA FORM 5441-47 – Evaluation Of Clinical Privileges – Preventive Medicine is a vital tool for maintaining high standards in preventive healthcare. By ensuring that healthcare providers meet the necessary qualifications and competencies, the form helps protect patient care and uphold the quality of medical services. Understanding and properly utilizing this form is essential for healthcare administrators and providers within the preventive medicine field.
For more information or to access DA FORM 5441-47, individuals can refer to the prescribing directive AR 40-68 or contact the relevant medical administration authorities.
DA FORM 5441-47 Fillable – Army Pubs 5441-47 PDF DOWNLOAD
