AF Form 4172 - Clinical Privileges - Clinical Pharmacist

AF Form 4172 - Clinical Privileges - Clinical Pharmacist serves as a clinical privileges form for clinical pharmacists seeking to provide healthcare services within the Air Force Medical Service.

This form includes sections for personal and professional information, clinical privileges requested, and signatures. It is used to assess the qualifications and experience of clinical pharmacists and grant them clinical privileges accordingly.

An example scenario for using AF Form 4172 is when a clinical pharmacist applies for clinical privileges to offer pharmaceutical services within an Air Force medical facility. This form streamlines the privileging process, ensuring that qualified clinical pharmacists can contribute to patient care.