DA Form 5441-44. Evaluation of Clinical Privileges - Otolaryngology

DA Form 5441-44 serves the purpose of evaluating clinical privileges for Otolaryngology practitioners. This form is essential for assessing and establishing the qualifications and requested privileges for medical professionals specializing in diagnosing and treating ear, nose, and throat disorders.

The form comprises sections where the otolaryngologist provides personal and professional details, including licenses, certifications, and qualifications specific to otolaryngology practice. It requires outlining the requested clinical privileges, covering areas such as ENT examinations, surgical procedures, and medical management of ENT conditions.

Key fields in this form include the otolaryngologist's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in otolaryngology. Accurate completion of this form is vital to ensure that the practitioner is granted privileges aligned with their proficiency in diagnosing and treating disorders of the ear, nose, and throat.

Application Example: An otolaryngologist joining a military medical facility would utilize DA Form 5441-44 to request clinical privileges. By accurately completing the form and providing necessary documentation, the practitioner's proficiency in ENT examinations 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 5441-41, 5441-42, 5441-43, and 5441-45 are related forms intended for different clinical privilege evaluation processes.