DA Form 5441-7. Evaluation of Clinical Privileges-Pathology

DA Form 5441-7 is designed for evaluating clinical privileges in the field of Pathology. This form serves the purpose of assessing and establishing the qualifications and requested privileges for medical professionals specializing in the study of diseases and their effects on the body.

The form is organized into sections where the pathology specialist provides their personal and professional details, including licenses, certifications, and qualifications pertinent to the practice of pathology. It requires outlining the requested clinical privileges, covering areas such as diagnostic evaluations, tissue analysis, and disease identification.

Key fields in this form include the specialist's identification information, requested clinical privileges, and supporting documentation that demonstrates their expertise in pathology. Accurate completion of this form is crucial to ensure that the practitioner is granted privileges aligned with their proficiency in diagnosing and understanding diseases.

Application Example: A pathologist joining a military medical facility would use DA Form 5441-7 to request clinical privileges. By accurately completing the form and providing necessary documentation, the practitioner's proficiency in diagnostic evaluations and disease identification 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 5441-8, 5441-9, 5448-R, and 5450-R are related forms intended for different clinical privilege evaluation processes.