AF Form 1540A - Application for Clinical Privileges/Medical Staff Appointment Update

AF Form 1540A - Application for Clinical Privileges/Medical Staff Appointment Update serves as an update form for healthcare professionals to maintain and update their clinical privileges or medical staff appointments within the Air Force Medical Service (AFMS).

This form includes sections for updating the applicant's professional information, qualifications, training, and any changes to their clinical privileges or appointment details. It is used to ensure that healthcare professionals' information is current and accurately reflects their qualifications and responsibilities within AFMS facilities.

An example scenario for using AF Form 1540A is when a healthcare provider already holds clinical privileges or a medical staff appointment within an Air Force medical facility and needs to update their information or request changes to their privileges or appointment. This form facilitates the maintenance and accuracy of healthcare provider records within AFMS.