DA Form 5441-9. Evaluation of Clinical Privileges-Podiatry

DA Form 5441-9 is used to evaluate clinical privileges in the field of Podiatry. This form serves the purpose of assessing and establishing the qualifications and requested privileges for medical professionals specializing in the diagnosis and treatment of foot and ankle conditions.

The form is organized into sections where the podiatry specialist provides personal and professional details, including licenses, certifications, and qualifications specific to podiatry practice. It requires outlining the requested clinical privileges, covering areas such as foot and ankle surgeries, wound care, and orthotic interventions.

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

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