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DA Form 5441-21 Evaluation of Clinical Privileges - Physical Therapy
What Is DA Form 5441-21?
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 5441-21, 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 5441-21?
A: DA Form 5441-21 is an Evaluation of Clinical Privileges form specifically for Physical Therapy.
Q: Who uses DA Form 5441-21?
A: DA Form 5441-21 is typically used by Physical Therapists and healthcare facilities that grant clinical privileges.
Q: What is the purpose of DA Form 5441-21?
A: The purpose of DA Form 5441-21 is to assess and evaluate the clinical privileges of Physical Therapists.
Q: Is DA Form 5441-21 specific to the United States or Canada?
A: DA Form 5441-21 is specific to the United States.
Form Details:
- A 1-page document available for download in PDF;
- The latest version available from the Army Publishing Directorate;
- Editable, free, and easy to use;
- Fill out the form in our online filing application.
Download an up-to-date printable DA Form 5441-21 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
