DA Form 5441-38. Evaluation of Clinical Privileges - Clinical Pharmacy

DA Form 5441-38 serves the purpose of evaluating clinical privileges for Clinical Pharmacy practitioners. This form is essential for assessing and establishing the qualifications and requested privileges for pharmacy professionals specializing in providing clinical pharmaceutical care.

The form comprises sections where the clinical pharmacist provides personal and professional details, including licenses, certifications, and qualifications specific to clinical pharmacy practice. It requires outlining the requested clinical privileges, covering areas such as medication therapy management, drug information consultations, and pharmacotherapy interventions.

Important fields in this form include the clinical pharmacist's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in clinical pharmacy practice. Accurate completion of this form is crucial to ensure that the practitioner is granted privileges aligned with their proficiency in delivering clinical pharmaceutical care.

Application Example: A Doctor of Pharmacy (Pharm.D.) joining a military medical facility would utilize DA Form 5441-38 to request clinical privileges. By accurately completing the form and providing necessary documentation, the pharmacist's proficiency in medication therapy management and drug information consultations 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 5441-37, 5441-39, 5441-4, and 5441-40 are related forms intended for different clinical privilege evaluation processes.