DA Form 5441-51. Evaluation of Clinical Privileges - Neurosurgery

DA Form 5441-51 serves the purpose of evaluating clinical privileges for Neurosurgery practitioners. This form plays a significant role in assessing and establishing the qualifications and requested privileges for medical professionals specializing in surgical procedures involving the nervous system.

The form comprises sections where the neurosurgeon provides personal and professional details, including licenses, certifications, and qualifications specific to neurosurgery practice. It requires outlining the requested clinical privileges, covering areas such as brain surgeries, spinal procedures, and neurological disorder interventions.

Important fields in this form include the surgeon's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in neurosurgery. Accurate completion of this form is vital to ensure that the practitioner is granted privileges aligned with their proficiency in performing complex surgical procedures on the nervous system.

Application Example: A board-certified neurosurgeon joining a military medical facility would use DA Form 5441-51 to request clinical privileges. By accurately completing the form and providing necessary documentation, the practitioner's proficiency in brain surgeries and spinal procedures 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 5441-50, 5441-52, 5441-53, and 5441-54 are related forms intended for different clinical privilege evaluation processes.