DA Form 5441-55. Evaluation of Clinical Privileges - Orthopaedics

DA Form 5441-55 is utilized to evaluate clinical privileges in the field of Orthopaedics. This form plays a pivotal role in assessing and establishing the qualifications and requested privileges for medical professionals specializing in surgical and medical interventions related to the musculoskeletal system.

The form consists of sections where the orthopaedic specialist provides personal and professional details, including licenses, certifications, and qualifications specific to orthopaedics practice. It requires outlining the requested clinical privileges, covering areas such as joint surgeries, fracture management, and orthopaedic trauma interventions.

Key fields in this form include the specialist's identification information, requested clinical privileges, and supporting documentation showcasing their expertise in orthopaedics. Accurate completion of this form is essential to ensure that the practitioner is granted privileges aligned with their proficiency in diagnosing and treating musculoskeletal conditions.

Application Example: An orthopaedic surgeon joining a military medical facility would use DA Form 5441-55 to request clinical privileges. By accurately completing the form and providing necessary documentation, the practitioner's proficiency in joint surgeries and orthopaedic trauma 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 5441-56, 5441-57, 5441-58, and 5441-6 are related forms intended for different clinical privilege evaluation processes.