DA Form 5440-46. Delineation of Clinical Privileges - Pulmonary Disease

DA Form 5440-46 is intended for the delineation of clinical privileges in the field of Pulmonary Disease. This form facilitates the documentation and evaluation of a medical practitioner's qualifications and requested privileges related to respiratory and pulmonary medical care.

The form includes sections where the practitioner provides their personal information, medical licenses, certifications, and qualifications. It also requires detailing the requested clinical privileges, encompassing diagnostic procedures, therapeutic interventions, and other relevant medical services within the realm of pulmonary care.

Important fields in this form include the practitioner's identification details, requested clinical privileges, and supporting documents demonstrating their expertise in pulmonary disease. Accurate completion of this form is essential to ensure that the practitioner is granted clinical privileges aligned with their qualifications and experience.

Application Example: A certified pulmonary specialist joining a military medical facility would utilize DA Form 5440-46 to request clinical privileges. By accurately completing the form and submitting supporting documentation, the practitioner's proficiency in pulmonary medicine is assessed, enabling the medical facility to grant appropriate privileges.

No additional documents are explicitly mentioned as required for filling this form.

Related Form: DA Form 5440-43, 5440-44, 5440-45, and 5440-47 are related forms intended for different medical specialties, each tailored for specific clinical privileges.