DAFORMFILLABLE.COM | DA FORM 5440-40 Fillable – Army Pubs ANGKA PDF – DA FORM 5440-40 – Delineation Of Clinical Privileges – Therapeutic Radiology is an essential document used in the field of therapeutic radiology to outline the clinical privileges granted to healthcare professionals. This article provides an in-depth understanding of the form, its usage, and its significance.
DA FORM 5440-40 – Delineation Of Clinical Privileges – Therapeutic Radiology
Form Number | DA Form 5440-40 |
Form Title | Delineation Of Clinical Privileges – Therapeutic Radiology |
Form Date | 02/01/2004 |
Form Proponent | TSG |
Overview of DA FORM 5440-40
DA FORM 5440-40, titled Delineation Of Clinical Privileges – Therapeutic Radiology, was published on February 1, 2004. The form is actively used and maintained by the TSG (The Surgeon General). It is prescribed by AR 40-68, which provides guidelines on clinical privileges.
Key Details
- Pub/Form Number: DA FORM 5440-40
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Delineation Of Clinical Privileges – Therapeutic Radiology
- Proponent: TSG
- Status: Active
- Prescribed Directive: AR 40-68
- Footnotes:
- 14: Requires Privacy Act Statement (AR 340-21)
- 42: Item only produced in electronic media
- Security Classification: Unclassified
- Distribution Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 081312
Purpose and Importance
The primary purpose of DA FORM 5440-40 is to delineate the specific clinical privileges assigned to medical professionals within the field of therapeutic radiology. This ensures that only qualified and authorized individuals perform specialized radiological procedures, maintaining high standards of patient care and safety.
Clinical Privileges in Therapeutic Radiology
Clinical privileges are the permissions granted to healthcare providers to perform certain medical procedures. In therapeutic radiology, these privileges might include, but are not limited to:
- Administration of radiation therapy
- Conducting imaging studies
- Performing specialized radiological techniques
How to Use DA FORM 5440-40
Completing the Form
Healthcare facilities must ensure that DA FORM 5440-40 is accurately completed for each professional seeking clinical privileges in therapeutic radiology. The form requires detailed information about the practitioner’s qualifications, experience, and competencies.
Submission and Approval
Once completed, the form is submitted to the appropriate authority within the medical facility. It undergoes a review process to verify the credentials and qualifications of the applicant. Upon approval, the practitioner is granted the specified clinical privileges.
Compliance and Privacy
Privacy Act Statement
The form requires adherence to the Privacy Act Statement (AR 340-21), ensuring that all personal information provided is protected and used solely for the intended purpose of credentialing.
Electronic Media Production
As indicated by footnote 42, DA FORM 5440-40 is produced exclusively in electronic media, facilitating easier distribution, completion, and storage.
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Conclusion
DA FORM 5440-40 – Delineation Of Clinical Privileges – Therapeutic Radiology plays a crucial role in the credentialing process of healthcare professionals in the field of therapeutic radiology. By understanding its purpose, usage, and compliance requirements, medical facilities can ensure that they maintain high standards of patient care and safety. Properly completing and managing this form is essential for the effective and secure operation of therapeutic radiology services.