DA Form 5440-10 Delineation of Clinical Privileges-Psychiatry

What Is DA Form 5440-10?

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.

FAQ

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.