DA Form 5441-33. Evaluation of Clinical Privileges - Urology

DA Form 5441-33 is intended for evaluating clinical privileges within the field of Urology. This form serves the crucial purpose of assessing and establishing the qualifications and requested privileges for medical practitioners specializing in diagnosing and treating urinary tract and male reproductive system disorders.

The form includes sections where the urologist provides personal and professional details, including licenses, certifications, and qualifications specific to urology practice. It necessitates outlining the requested clinical privileges, covering areas such as urological assessments, surgical interventions, and treatment of urologic conditions.

Important fields in this form include the urologist's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in urology. Accurate completion of this form is vital to ensure that the practitioner is granted privileges aligned with their proficiency in diagnosing and treating urologic conditions.

Application Example: A urologist joining a military medical facility would utilize DA Form 5441-33 to request clinical privileges. By accurately completing the form and providing necessary documentation, the practitioner's proficiency in urological assessments and surgical interventions 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 5441-32, 5441-34, 5441-35, and 5441-36 are related forms intended for different clinical privilege evaluation processes.