DA Form 5440-12 Delineation of Clinical Privileges-Diagnostic Radiology

DA Form 5440-12 Delineation of Clinical Privileges-Diagnostic Radiology

What Is DA Form 5440-12?

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 5440-12, 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 5440-12?
A: DA Form 5440-12 is a form used for delineating clinical privileges in the field of Diagnostic Radiology.

Q: What is the purpose of DA Form 5440-12?
A: The purpose of DA Form 5440-12 is to outline and document the specific clinical privileges granted to a healthcare provider in the field of Diagnostic Radiology.

Q: Who uses DA Form 5440-12?
A: DA Form 5440-12 is used by healthcare providers and medical facilities involved in Diagnostic Radiology.

Q: What is meant by delineation of clinical privileges?
A: Delineation of clinical privileges refers to the process of defining and specifying the specific medical procedures or services that a healthcare provider is authorized to perform.

Q: What is Diagnostic Radiology?
A: Diagnostic Radiology is a medical specialty that uses imaging techniques such as X-rays, CT scans, MRIs, and ultrasounds to diagnose and treat different medical conditions.

Q: Why is delineation of clinical privileges important?
A: Delineation of clinical privileges is important to ensure patient safety, quality of care, and to establish accountability and competence among healthcare providers.

Q: Are there any specific requirements for completing DA Form 5440-12?
A: Specific requirements for completing DA Form 5440-12 may vary, and it is recommended to consult the relevant medical facility or regulatory authority for the specific guidelines and instructions.

Q: Is DA Form 5440-12 specific to the United States?
A: Yes, DA Form 5440-12 is specific to the United States Army and is primarily used within the U.S. military healthcare system.

Q: Can civilians in the United States use DA Form 5440-12?
A: DA Form 5440-12 is primarily used within the U.S. military healthcare system, but it may have limited applicability to civilian healthcare providers or organizations.

Q: Is DA Form 5440-12 required by law?
A: Compliance with DA Form 5440-12 may be required by military regulations and policies, but its applicability and legal requirements may vary.

Q: Can healthcare providers in Canada use DA Form 5440-12?
A: DA Form 5440-12 is specific to the United States Army and its use in Canada may be limited. Canadian healthcare providers should consult with their respective regulatory authorities for the appropriate documentation requirements.

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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;

Download an up-to-date printable DA Form 5440-12 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 5440-12 Delineation of Clinical Privileges-Diagnostic Radiology

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