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 5440-10, 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.
Q: What is DA Form 5440-10?
A: DA Form 5440-10 is a form used for delineation of clinical privileges in the field of psychiatry.
Q: What is the purpose of DA Form 5440-10?
A: The purpose of DA Form 5440-10 is to clearly outline the clinical privileges and specific responsibilities of psychiatrists.
Q: Who uses DA Form 5440-10?
A: DA Form 5440-10 is used by psychiatrists in the military or other government agencies to establish their clinical privileges.
Q: What information does DA Form 5440-10 include?
A: DA Form 5440-10 includes personal information, education and training, clinical experience, and areas of practice for the psychiatrist.
Q: How is DA Form 5440-10 filled out?
A: DA Form 5440-10 is typically completed by the psychiatrist, with input from their supervisors or credentialing committee.
Q: Why is clinical privilege delineation important?
A: Clinical privilege delineation is important to ensure that psychiatrists have the appropriate qualifications and skills to provide safe and effective care to patients.
Q: Are there any fees associated with DA Form 5440-10?
A: There are usually no fees associated with DA Form 5440-10, as it is an internal form used for credentialing purposes.
Q: Can DA Form 5440-10 be submitted electronically?
A: The submission process for DA Form 5440-10 may vary depending on the organization, but electronic submission is becoming more common.
Q: Is DA Form 5440-10 specific to psychiatry?
A: Yes, DA Form 5440-10 is specific to psychiatry and is used to delineate clinical privileges for psychiatrists.
Form Details:
Download an up-to-date fillable DA Form 5440-10 down below in PDF format or browse hundreds of other DA Forms stored in our online database.