DAFORMFILLABLE.COM | DA FORM 5441-22 Fillable – Army Pubs 5441-22 PDF – The DA FORM 5441-22 – Evaluation Of Clinical Privileges is a crucial document within the U.S. Army Medical Department. This form is used to evaluate and document the clinical privileges of healthcare providers. Understanding the purpose, usage, and regulations surrounding this form is essential for medical personnel within the Army.
DA FORM 5441-22 – Evaluation Of Clinical Privileges
| Form Number | DA Form 5441-22 |
| Form Title | Evaluation Of Clinical Privileges |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose of DA FORM 5441-22
The primary purpose of DA FORM 5441-22 is to assess the clinical capabilities of medical staff, ensuring that they meet the necessary standards to perform specific clinical duties. This evaluation is part of a comprehensive credentialing process that aims to maintain high standards of medical care within the Army.
Key Elements of DA FORM 5441-22
- Pub/Form Number: DA FORM 5441-22
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Evaluation Of Clinical Privileges
- Pub/Form Proponent: TSG (The Surgeon General)
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 40-68
- Footnotes:
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
- Security Classification: UNCLASSIFIED
- Distribution Restriction Code: A (APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED)
- Pub/Form IDN: 990001
- Pub/Form PIN: 066553
Usage and Regulations
The DA FORM 5441-22 is mandated by AR 40-68, which outlines the policies and procedures for credentialing healthcare providers in the Army. This regulation ensures that all healthcare personnel are evaluated consistently and thoroughly before being granted clinical privileges.
Importance of Compliance
Compliance with the evaluation process using DA FORM 5441-22 is essential for several reasons:
- Quality of Care: Ensures that only qualified personnel provide medical care.
- Accountability: Maintains a record of the qualifications and evaluations of healthcare providers.
- Legal Protection: Provides documentation that can be used in legal proceedings if necessary.
Completing DA FORM 5441-22
The form requires detailed information about the healthcare provider’s qualifications, including education, training, experience, and specific clinical competencies. Evaluators must provide an objective assessment based on established criteria.
Privacy and Security
As indicated in the footnotes, DA FORM 5441-22 requires a Privacy Act Statement (AR 340-21) to protect the personal information of the healthcare providers being evaluated. This form is only produced in electronic media, ensuring that it is easily accessible while maintaining security standards.
Distribution and Accessibility
The form is approved for public release, with unlimited distribution, ensuring transparency and accessibility for those involved in the credentialing process. The unclassified nature of the form means it can be freely shared and reviewed without security concerns.
How to Access DA FORM 5441-22
The DA FORM 5441-22 can be accessed through official Army publications and electronic media platforms. It is essential for medical personnel and administrative staff involved in the credentialing process to be familiar with how to obtain and complete this form correctly.
Conclusion
The DA FORM 5441-22 – Evaluation Of Clinical Privileges is a fundamental component of the Army’s healthcare credentialing process. By ensuring that all healthcare providers are thoroughly evaluated and meet the necessary standards, this form helps maintain high-quality medical care within the Army. Understanding and complying with the requirements of this form is essential for all medical personnel and administrative staff involved in the credentialing process.
DA FORM 5441-22 Fillable – Army Pubs 5441-22 PDF DOWNLOAD
