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DA Form 5440-6 Delineation of Clinical Privileges-Optometry Service
What Is DA Form 5440-6?
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 5440-6, 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 5440-6?
A: DA Form 5440-6 is a form used to delineate clinical privileges for the Optometry Service.
Q: What is the purpose of DA Form 5440-6?
A: The purpose of DA Form 5440-6 is to define the scope of practice and clinical privileges for optometrists.
Q: Who uses DA Form 5440-6?
A: Optometrists and the healthcare facilities they work in use DA Form 5440-6.
Q: What does 'delineate clinical privileges' mean?
A: 'Delineate clinical privileges' refers to specifying the specific clinical activities and procedures that an optometrist is authorized to perform.
Q: Why is it important to have a delineation of clinical privileges for optometrists?
A: A delineation of clinical privileges ensures that optometrists are practicing within their defined scope of practice and have the necessary authorization to perform specific clinical activities.
Q: Is DA Form 5440-6 specific to the United States?
A: Yes, DA Form 5440-6 is specific to the United States and is used in the military healthcare system.
Q: Can optometrists practice without a delineation of clinical privileges?
A: No, optometrists must have a delineation of clinical privileges in order to practice and have authorization to perform specific clinical activities.
Q: Can optometrists request changes to their delineation of clinical privileges?
A: Yes, optometrists can request changes to their delineation of clinical privileges based on their training, experience, and additional qualifications.
Q: Who approves changes to the delineation of clinical privileges?
A: Changes to the delineation of clinical privileges are typically approved by the relevant healthcare facility's credentialing committee or authority.
Form Details:
- A 2-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 5440-6 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
Download DA Form 5440-6 Delineation of Clinical Privileges-Optometry Service
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