DA 5440-01-R through DA 5517-R
FORM NO. | FORM DATE | TITLE | |
DA 5440-1 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – DENTISTRY |
|
DA 5440-10 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PSYCHIATRY |
|
DA 5440-11 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CLINICAL PSYCHOLOGY |
|
DA 5440-12 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – DIAGNOSTIC RADIOLOGY |
|
DA 5440-13 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – GENERAL SURGERY |
|
DA 5440-14 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – NURSE ANESTHETIST |
|
DA 5440-15 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CERTIFIED NURSE MIDWIFE |
|
DA 5440-16 | FB 04 | DELINEATION OF CLINICAL PRIVILEGES – NURSE PRACTITIONER |
|
DA 5440-18 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PHYSICIAN ASSISTANT |
|
DA 5440-19 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – DIETETICS |
|
DA 5440-2 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – FAMILY PRACTICE |
|
DA 5440-20 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OCCUPATIONAL THERAPY |
|
DA 5440-21 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PHYSICAL THERAPY |
|
DA 5440-22 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES |
|
DA 5440-23 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – EMERGENCY MEDICINE |
|
DA 5440-24 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – AEROSPACE MEDICINE |
|
DA 5440-25 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – GENERAL MEDICAL OFFICER |
|
DA 5440-28 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES |
|
DA 5440-29 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – ALLERGY/IMMUNOLOGY |
|
DA 5440-3 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – INTERNAL MEDICINE |
|
DA 5440-30 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – NEPHROLOGY |
|
DA 5440-31 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CHIROPRACTIC |
|
DA 5440-32 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – DERMATOLOGY |
|
DA 5440-33 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – UROLOGY |
|
DA 5440-34 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – BEHAVIORAL HEALTH PRACTIONER |
|
DA 5440-35 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PSYCHOLOGICAL ASSOCIATE |
|
DA 5440-36 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – AUDIOLOGY |
|
DA 5440-37 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – SPEECH PATHOLOGY |
|
DA 5440-38 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CLINICAL PHARMACY |
|
DA 5440-39 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – NUCLEAR MEDICINE |
|
DA 5440-4 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – NEUROLOGY |
|
DA 5440-40 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – THERAPEUTIC RADIOLOGY |
|
DA 5440-41 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PHYSICAL MEDICINE AND REHABILITATION |
|
DA 5440-42 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CARDIOLOGY |
|
DA 5440-43 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OPHTHAMOLOGY |
|
DA 5440-44 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OTOLARYNGOLOGY |
|
DA 5440-45 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CARDIOVASCULAR SURGERY |
|
DA 5440-46 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PULMONARY DISEASE |
|
DA 5440-47 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PREVENTIVE MEDICINE |
|
DA 5440-48 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – ORAL & MAXILLOFACIAL SURGERY |
|
DA 5440-49 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PLASTIC SURGERY |
|
DA 5440-5 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OBSTETRICS AND GYNECOLOGY |
|
DA 5440-50 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – VASCULAR SURGERY |
|
DA 5440-51 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – NEUROSURGERY |
|
DA 5440-52 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – CRITICAL CARE MEDICINE |
|
DA 5440-53 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OCCUPATIONAL MEDICINE |
|
DA 5440-54 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – THORACIC SURGERY |
|
DA 5440-55 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – ORTHOPAEDICS |
|
DA 5440-56 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – BLOOD SERVICES |
|
DA 5440-57 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PSYCHIATRIC ADVANCED PRACTICE NURSE |
|
DA 5440-58 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – SUBSTANCE ABUSE REHABILITATION |
|
DA 5440-6 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – OPTOMETRY |
|
DA 5440-7 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PATHOLOGY |
|
DA 5440-8 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PEDIATRICS |
|
DA 5440-9 | FEB 04 | DELINEATION OF CLINICAL PRIVILEGES – PODIATRY |
|
DA 5440A | FEB 04 | APPROVAL OF CLINICAL PRIVILEGES/STAFF APPOINTMENT |
|
DA 5441 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – ANESTHESIA |
|
DA 5441-1 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – DENTISTRY |
|
DA 5441-10 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PSYCHIATRY |
|
DA 5441-11 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CLINICAL PSYCHOLOGY |
|
DA 5441-12 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – DIAGNOSTIC RADIOLOGY |
|
DA 5441-13 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – GENERAL SURGERY |
|
DA 5441-14 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NURSE ANESTHETIST |
|
DA 5441-15 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CERTIFIED NURSE MIDWIFE |
|
DA 5441-16 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NURSE PRACTITIONER |
|
DA 5441-18 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PHYSICIAN ASSISTANT |
|
DA 5441-19 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – DIETETICS |
|
DA 5441-2 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – FAMILY PRACTICE |
|
DA 5441-20 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OCCUPATIONAL THERAPY |
|
DA 5441-21 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PHYSICAL THERAPY |
|
DA 5441-22 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES |
|
DA 5441-23 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – EMERGENCY MEDICINE |
|
DA 5441-24 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – AEROSPACE MEDICINE |
|
DA 5441-25 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – GENERAL MEDICAL OFFICER |
|
DA 5441-28 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – SOCIAL WORK |
|
DA 5441-29 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – ALLERGY/IMMUNOLOGY |
|
DA 5441-3 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – INTERNAL MEDICINE |
|
DA 5441-30 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NEPHROLOGY |
|
DA 5441-31 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CHIROPRACTIC |
|
DA 5441-32 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – DERMATOLOGY |
|
DA 5441-33 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – UROLOGY |
|
DA 5441-34 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – BEHAVIORAL HEALTH PRACTITIONER |
|
DA 5441-35 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PSYCHOLOGICAL ASSOCIATE |
|
DA 5441-36 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – AUDIOLOGY |
|
DA 5441-37 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – SPEECH PATHOLOGY |
|
DA 5441-38 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CLINICAL PHARMACY |
|
DA 5441-39 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NUCLEAR MEDICINE |
|
DA 5441-4 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NEUROLOGY |
|
DA 5441-40 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – THERAPEUTIC RADIOLOGY |
|
DA 5441-41 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PHYSICAL MEDICINE AND REHABILITATION |
|
DA 5441-42 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CARDIOLOGY |
|
DA 5441-43 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OPHTHALMOLOGY |
|
DA 5441-44 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OTOLARYNGOLOGY |
|
DA 5441-45 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CARDIOVASCULAR SURGERY |
|
DA 5441-46 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PULMONARY DISEASE |
|
DA 5441-47 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PREVENTIVE MEDICINE |
|
DA 5441-48 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – ORAL & MAXILLOFACIAL SURGERY |
|
DA 5441-49 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PLASTIC SURGERY |
|
DA 5441-5 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OBSTETRICS AND GYNECOLOGY |
|
DA 5441-50 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – VASCULAR SURGERY |
|
DA 5441-51 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – NEUROSURGERY |
|
DA 5441-52 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – CRITICAL MEDICINE |
|
DA 5441-53 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OCCUPATIONAL MEDICINE |
|
DA 5441-54 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – THORACIC SURGERY |
|
DA 5441-55 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – ORTHOPAEDICS |
|
DA 5441-56 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – BLOOD SERVICES |
|
DA 5441-57 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PSYCHIATRIC ADVANCED PRACTICE NURSE |
|
DA 5441-58 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – SUBSTANCE ABUSE REHABILITATION |
|
DA 5441-6 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – OPTOMETRY |
|
DA 5441-7 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PATHOLOGY |
|
DA 5441-8 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PEDIATRICS |
|
DA 5441-9 | FEB 04 | EVALUATION OF CLINICAL PRIVILEGES – PODIATRY |
|
DA 5447-R | FEB 96 | OFFICER SERVICE AGREEMENT SELECTED RESERVE EDUCATIONAL ASSISTANCE PROGRAM (SHORT TITLE: MONTGOMERY GI BILL) |
|
DA 5448-R | AUG 85 | MOISTURE & DENSITY TESTER FIELD DATA WORKSHEET |
|
DA 5450-R | AUG 85 | MOISTURE & DENSITY FIELD TEST SHEET |
|
DA 5454-R | JUL 93 | REQUEST FOR ARMY/AMERICAN COUNCIL ON EDUCATION REGISTRY TRANSCRIPT |
|
DA 5456 | NOV 05 | WATER POINT INSPECTION |
|
DA 5457 | NOV 05 | POTABLE WATER CONTAINER INSPECTION |
|
DA 5458 | NOV 05 | SHOWER/DECONTAMINATION POINT INSPECTION |
|
DA 5459 | OCT 03 | AUTHORIZATION TO RELEASE INFORMATION FROM ARMY RECORDS ON NONSUPPORT/CHILD CUSTODY/PATERNITY INQUIRIES |
|
DA 5462 | JUN 04 | TIP ALLOCATION WORKSHEET |
|
DA 5462-1 | JUN 04 | CONTINUATION OF TIP ALLOCATION WORKSHEET |
|
DA 5463-R PDF ONLY |
OCT 85 | PETROLEUM PRODUCTS TANK FARM OUTTURN RECORD |
|
DA 5464-R PDF ONLY |
OCT 85 | PETROLEUM PRODUCTS PIPELINE LEAKAGE REPORT |
|
DA 5467-R | OCT 85 | CIVILIAN CLEARANCE RECORD |
|
DA 5468-R | OCT 85 | EXIT QUESTIONNAIRE |
|
DA 5473-R | NOV 85 | PERFORMANCE REQUIREMENTS SUMMARY |
|
DA 5475-R | NOV 85 | COR/QAE SURVEILLANCE SCHEDULE |
|
DA 5476-R | NOV 85 | SURVEILLANCE ACTIVITY CHECKLIST |
|
DA 5477-R | NOV 85 | CUSTOMER COMPLAINT RECORD |
|
DA 5478-R | NOV 85 | DECISION TABLE | |
DA 5479-R | NOV 85 | CONTRACT DISCREPANCY REPORT |
|
DA 5480 | JUN 03 | MAINTENANCE REQUEST AND ASSIGNMENT REGISTER |
|
DA 5481-R | NOV 85 | TALLY CHECKLIST | |
DA 5484-R | FEB 96 | MISSION SCHEDULE/BRIEF |
|
DA 5500-R | DEC 85 | BODY FAT CONTENT WORKSHEET (MALE) |
|
DA 5501-R | DEC 85 | BODY FAT CONTENT WORKSHEET (FEMALE) |
|
DA 5511-R PDF ONLY |
FEB 86 | PERSONAL WEIGHT LOSS PROGRESS |
|
DA 5512 | SEP 02 | RESPITE CARE AGREEMENT |
|
DA 5513-R | AUG 93 | KEY CONTROL REGISTER AND INVENTORY |
|
DA 5514-R | APR 86 | TAMIS TRAINING AMMUNITION FORECAST REPORT |
|
DA 5515 | MAY 04 | TRAINING AMMUNITION CONTROL DOCUMENT |
|
DA 5515-1 | MAY 04 | TRAINING AMMUNITION CONTROL DOCUMENT CONTINUATION SHEET |
|
DA 5517-R | FEB 86 | STANDARD RANGE CARD |