DAFORMFILLABLE.COM | DA FORM 5441-19 Fillable – Army Pubs 5441-19 PDF – DA FORM 5441-19 – Evaluation Of Clinical Privileges – Dietetics is a critical document used by the United States Army to assess the clinical competencies of dietitians. This form, dated 02/01/2004, ensures that dietetic professionals are evaluated accurately and consistently according to their clinical privileges. Governed by AR 40-68, the form is essential for maintaining high standards in dietetic care within the military.
DA FORM 5441-19 – Evaluation Of Clinical Privileges – Dietetics
| Form Number | DA Form 5441-19 |
| Form Title | Evaluation Of Clinical Privileges – Dietetics |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance of DA FORM 5441-19
Ensuring High Standards in Dietetics
The primary purpose of DA FORM 5441-19 is to evaluate the clinical privileges of dietitians. This ensures that only qualified individuals are authorized to provide dietetic services within military medical facilities. By maintaining rigorous evaluation standards, the Army upholds the quality of healthcare services provided to its personnel.
Compliance with Regulatory Directives
The form is prescribed by AR 40-68, which outlines the requirements for healthcare credentialing and privileging. It is crucial for dietitians to comply with these regulations to maintain their eligibility for clinical privileges. Additionally, the form includes a Privacy Act Statement as required by AR 340-21, ensuring that personal information is handled according to privacy regulations.
Key Features of DA FORM 5441-19
Electronic Availability
DA FORM 5441-19 is produced exclusively in electronic media, which facilitates easy access and distribution. This format also ensures that the most current version of the form is always available for use, reducing the risk of outdated information being used in evaluations.
Unclassified Status and Distribution
The form is classified as UNCLASSIFIED and has a distribution restriction code A, indicating that it is approved for public release and distribution is unlimited. This openness ensures transparency and accessibility for all personnel involved in the evaluation process.
Completing DA FORM 5441-19
Sections of the Form
The form is divided into several sections, each designed to capture specific information about the dietitian’s competencies and clinical performance. These sections typically include:
- Personal Information: Details about the dietitian being evaluated.
- Clinical Privileges Requested: Specific privileges for which the dietitian is being evaluated.
- Evaluator’s Assessment: Detailed assessment by a qualified evaluator, including performance metrics and competency evaluations.
- Recommendations: Final recommendations regarding the approval or denial of the requested clinical privileges.
Privacy and Confidentiality
Given the sensitive nature of the information captured on DA FORM 5441-19, it is essential to adhere to privacy regulations. The form includes a Privacy Act Statement to ensure that all personal information is protected and used solely for the purpose of evaluating clinical privileges.
Conclusion
DA FORM 5441-19 – Evaluation Of Clinical Privileges – Dietetics plays a vital role in maintaining the quality and integrity of dietetic services within the United States Army. By providing a structured and standardized method for evaluating clinical competencies, this form helps ensure that dietitians are well-qualified to deliver high-quality care. Compliance with regulatory directives, electronic availability, and unclassified status make this form an essential tool for both dietitians and evaluators in the military healthcare system.
By understanding and utilizing DA FORM 5441-19 effectively, healthcare professionals can contribute to the ongoing excellence and reliability of dietetic services provided to military personnel.
DA FORM 5441-19 Fillable – Army Pubs 5441-19 PDF DOWNLOAD
