DA Form 5440-48 serves as a tool for delineating clinical privileges specifically within the domain of Oral & Maxillofacial Surgery. This form is essential for medical practitioners seeking to establish their qualifications and requested privileges related to surgical and dental procedures involving the mouth, jaws, and facial structures.
DA Form 5440-47 is designed to delineate clinical privileges in the field of Preventive Medicine. This form serves as a formal request for medical practitioners to establish their qualifications and requested privileges related to preventive health measures and public health interventions.
DA Form 5440-46 is intended for the delineation of clinical privileges in the field of Pulmonary Disease. This form facilitates the documentation and evaluation of a medical practitioner's qualifications and requested privileges related to respiratory and pulmonary medical care.
DA Form 5440-45 is designed to delineate clinical privileges in the field of Cardiovascular Surgery. This form serves as a formal request for medical practitioners to establish their qualifications and requested privileges related to cardiovascular surgical procedures.
The form comprises sections where the practitioner provides their personal and professional details, including medical licenses, certifications, and qualifications. It also requires a comprehensive outline of the requested clinical privileges, covering a range of cardiovascular surgical interventions.
DA Form 5440-44 is designed for the delineation of clinical privileges within the field of Otolaryngology. This form facilitates the documentation and evaluation of a medical practitioner's qualifications, experience, and requested privileges related to ear, nose, and throat (ENT) medical care.
DA Form 5440-43 is utilized for the delineation of clinical privileges specifically related to the field of Ophthalmology. This form serves as a comprehensive record for medical practitioners to request and establish the scope of clinical privileges within the realm of ophthalmic care.
DA Form 5440-42 is the Delineation of Clinical Privileges - Cardiology form used to establish and document the clinical privileges of cardiologists within the Department of the Army. This form outlines the scope of assessment and treatment procedures that cardiologists are authorized to perform.
The form consists of sections where the cardiologist's information is provided, including qualifications and requested cardiology privileges. It may also include sections for listing specific cardiology procedures and detailing any restrictions or limitations.
DA Form 5440-41 is the Delineation of Clinical Privileges - Physical Medicine and Rehabilitation form used to establish and document the clinical privileges of practitioners in the field of physical medicine and rehabilitation within the Department of the Army. This form outlines the scope of assessment and treatment procedures that practitioners are authorized to perform in the realm of physical medicine and rehabilitation.
DA Form 5440-40 is the Delineation of Clinical Privileges - Therapeutic Radiology form used to establish and document the clinical privileges of therapeutic radiologists within the Department of the Army. This form outlines the scope of therapeutic radiology assessment and treatment procedures that practitioners are authorized to perform.
DA Form 5440-4 is the Delineation of Clinical Privileges - Neurology form used to establish and document the clinical privileges of neurologists within the Department of the Army. This form outlines the scope of neurology assessment and treatment procedures that practitioners are authorized to perform.
The form consists of sections where the neurologist's information is provided, including their qualifications and requested privileges. It may also include sections for listing specific neurology procedures and detailing any restrictions or limitations.
