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DA Form 5441-47 is a Department of the Army form in the DA series. Title of record: EVALUATION OF CLINICAL PRIVILEGES - PREVENTIVE MEDICINE. Function: evaluation of clinical privileges - preventive medicine. The edition presently published bears the date 02/01/2004, with a status of ACTIVE. Physical extent is 2 page(s) and about unknown fillable fields.
Responsibility for content and revision lies with TSG. The prescribing directive is AR 40-68, which sets both the trigger for use and the disposition of the completed document. Entry is made by the named party or by the records clerk holding the file, with review and signature applied in the prescribed order. This edition has been superseded by a newer one. It is kept accessible for reference and for records already completed under it.
Formats offered: PDF, XFDL. All are the same published layout in different containers, and the choice between them is a matter of how the entries will be made rather than what appears on the page. The pdf serves as the authoritative rendering. A fillable pdf exposes editable fields on screen; a printable pdf is the blank form as a flat page for handwriting.
The pdf displays in current browsers and in any reader application. For fillable use a full reader is preferable to a browser viewer, since viewers vary in whether entered data is retained. An xfdl file is available too. The format is IBM Lotus Forms, in use across Army form systems, and it opens only in the Lotus Forms Viewer.
All formats are free to download and no registration is involved. The files are the published documents, distributed unmodified.
The blocks are worked through in the order they appear on the sheet. At the head sit the identifying entries: name, identification number, unit, date. Because the filed record is indexed on these, they precede everything substantive.
Typed entry is made straight into the interactive fields. The tab key moves through them in the order set at build time, generally matching the reading order of the page. Boxes and buttons respond to a click; in an exclusive group, one selection cancels the others. Single-line fields do not wrap, and anything longer than the field width prints cut off although it may still display in full on screen. Extended text goes to remarks or a continuation sheet rather than into a narrow box.
The signature block is completed last and by hand or by an accepted electronic means. An unsigned form is a draft. Where a second signature is called for — reviewing official, approving authority, witness — each is applied in the order the blocks appear and dated as of application, not as of preparation. Blank mandatory fields are the most frequent defect; a nil entry is marked as such rather than left empty. Other recurring faults: transposed digits in identification numbers, dates in the wrong order of day and month, and stale copies retaining prior data because a working file was reused instead of a fresh blank form.
Forms that collect personal information bear a Privacy Act statement covering authority, purpose, routine uses, and whether the disclosure is required or optional. Reading it precedes completion. Once filled, the document contains personal data and is subject to the handling and storage rules that attach to such records.
Once completed, the form goes where the governing authority directs: to the designated office, along the unit administrative channel, or into the personal file. The preparer retains a copy. The length of retention and the manner of filing are set by the records schedule for the series, not by local arrangement.
Related forms are found by series and number. Documents in the DA series sharing a proponent or a prescribing directive commonly travel together, and a form referenced within the body of another is usually filed with it. Continuation sheets, cover sheets, and transmittal documents belong to this group and are collected before submission rather than after.
Editions are replaced when the proponent revises the content. The edition date printed on the form is the means of telling one version from another, and the date on a downloaded copy is checked against the edition in force before use. Records already executed on a prior edition are not reworked on that account.
What is offered here are copies of published Department of the Army documents, made available for download. The site is independent of the Department of the Army and publishes no forms of its own. The material is informational and not legal advice, and no statement is made about whether any office will accept a given document. Questions of entry, requirement, or eligibility go to the proponent or the servicing administrative office.
Questions and answers
- What is DA Form 5441-47?
- EVALUATION OF CLINICAL PRIVILEGES - PREVENTIVE MEDICINE
- Which edition is current?
- 02/01/2004
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA,