DA Form 5441-31. Evaluation of Clinical Privileges - Chiropractic

DA Form 5441-31 is intended for evaluating clinical privileges in the field of Chiropractic care. This form is vital for assessing and establishing the qualifications and requested privileges for chiropractors involved in providing non-surgical musculoskeletal care and spinal adjustments.

The form includes sections where the chiropractor provides personal and professional details, including licenses, certifications, and qualifications specific to chiropractic practice. It requires outlining the requested clinical privileges, covering areas such as spinal assessments, chiropractic adjustments, and musculoskeletal treatments.

Key fields in this form include the chiropractor's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in chiropractic care. Accurate completion of this form is crucial to ensure that the chiropractor is granted privileges aligned with their proficiency in providing non-surgical musculoskeletal care.

Application Example: A licensed chiropractor joining a military medical facility would utilize DA Form 5441-31 to request clinical privileges. By accurately completing the form and providing necessary documentation, the chiropractor's proficiency in spinal assessments and musculoskeletal adjustments 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 5441-28, 5441-29, 5441-3, and 5441-30 are related forms intended for different clinical privilege evaluation processes.