DA Form 5440-1 Delineation of Clinical Privileges-Dentistry

What Is DA Form 5440-1?

This is a military form that was released by the U.S. Department of the Army (DA) on February 1, 2004. The form, often mistakenly referred to as the DD Form 5440-1, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

FAQ

Q: What is DA Form 5440-1?
A: DA Form 5440-1 is a form used for delineating clinical privileges in dentistry.

Q: What is the purpose of DA Form 5440-1?
A: The purpose of DA Form 5440-1 is to define the scope of clinical privileges for dentists.

Q: Who uses DA Form 5440-1?
A: DA Form 5440-1 is used by dentists in the United States and Canada.

Q: What does the form include?
A: The form includes information about the dentist's education, training, and experience, as well as details about the specific clinical privileges they are authorized to perform.

Q: Can dentists modify their clinical privileges?
A: Yes, dentists can request modifications to their clinical privileges by submitting a new DA Form 5440-1 and providing documentation of the necessary qualifications.

Q: Why is DA Form 5440-1 important?
A: DA Form 5440-1 is important as it ensures that dentists have the appropriate qualifications and training to perform specific clinical procedures, ensuring patient safety and quality of care.