DA Form 5440-8. Delineation of Clinical Privileges-Pediatrics

DA Form 5440-8 is designed for the delineation of clinical privileges within the field of Pediatrics. This form facilitates the documentation and evaluation of a medical practitioner's qualifications and requested privileges related to the care of infants, children, and adolescents.

The form comprises sections where the practitioner provides personal and professional details, including licenses, certifications, and qualifications. It also requires outlining the requested clinical privileges, covering areas such as well-child care, pediatric diagnostics, and treatment of pediatric medical conditions.

Key fields in this form include the practitioner's identification information, requested clinical privileges, and supporting evidence of their expertise in pediatric care. Accurate completion of this form is vital to ensure that the practitioner is granted privileges aligned with their proficiency in providing medical care to young patients.

Application Example: A board-certified pediatrician joining a military medical facility would use DA Form 5440-8 to request clinical privileges. By accurately completing the form and submitting necessary documentation, the pediatrician's proficiency in diagnosing and treating pediatric medical conditions is evaluated, enabling the medical facility to grant appropriate privileges.

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

Related Form: DA Form 5440-57, 5440-58, 5440-6, and 5440-7 are related forms intended for different medical specialties, each catering to specific clinical privileges.