You need DA Form 5441-32, and this page gets you to the file and through it. Start with what the form is: EVALUATION OF CLINICAL PRIVILEGES - DERMATOLOGY, used to evaluation of clinical privileges - dermatology. Check next that you have the right version — the edition dated 02/01/2004 is the one published here, and its status is ACTIVE. Then look at the size before you begin, because 2 page(s) and roughly unknown fields tell you how long this will take. Before you go further, note that a newer edition exists. Use this one only if you are looking at a record already completed on it.
Now decide who does the writing. Normally you enter your own particulars, then hand the sheet to the unit administrative office for review. If you work in that office, you enter what the individual brings you. From there the path is the same for everyone: TSG is responsible for the form, and AR 40-68 tells you what triggers it and where it ends up. Look at the directive first whenever your case departs from the ordinary.
Begin with the first block and follow the printed order. You will enter your name first, exactly as your official records show it, followed by your identification number, your organisation, and the date of preparation. Resist the urge to jump to the substantive blocks and return to the header later. Those first entries are the index for the whole record, and an error there costs you the ability to retrieve it.
In the body of the form, tab from field to field instead of clicking around. The tab order follows how the form was constructed, which keeps you from missing a box. For check boxes and option buttons, click them. If you find a set where the choices are exclusive, expect your new selection to clear the previous one. Keep an eye on long entries as you type: fields built for one line will not wrap, and what overflows the width will print truncated even though your screen shows all of it. At that point move the text into remarks or onto a continuation. And when something does not apply to you, say so in the field — write the entry that means "none" rather than leaving white space a reviewer has to interpret.
Save the signature for last. Sign by hand, or by whatever electronic method your office accepts, and understand that until you do the document is a draft no matter how complete it looks. If the form calls for a reviewing official, an approving authority, or a witness, take those signatures in the order the blocks print, and have each signer date it on the day they sign rather than the day you prepared it. Before you hand it over, read it once more from the top. You are looking for three things in particular: a mandatory field you left empty, digits transposed in your identification number, and a date written with day and month the wrong way round. Check one more thing if you built this form from a copy you had lying around — old entries survive in a reused file, and they will go forward as though you meant them.
You will find a Privacy Act statement on the form wherever personal information is collected. Read it at that point rather than skipping past it, because it tells you the authority for the collection, the purpose, the routine uses, and whether answering is mandatory. After you fill the form, remember that your copy contains personal data. Store it and transmit it as your office requires for records of that kind.
Download the form
Now pick your file. You have PDF, XFDL to choose from, and the choice depends on one thing: whether you will type the entries or write them by hand. Choose the fillable pdf when you want to type, tab between fields and keep a clean copy on your computer. Choose the printable pdf when you intend to print the blank first and write on paper. The pages look identical either way, so you are not giving anything up by picking the wrong one — you are only choosing how you work.
After you download, open the file the right way. Double-click a pdf and your browser may take it, which is fine for reading but risky for filling: some browser viewers show you the fields, let you type, and then lose the text when you close the tab. Save the file to your computer first, then open it in a full pdf reader, and check that your entries survive a save before you type the whole form. If you downloaded the xfdl file, do not try a pdf reader on it. That format is IBM Lotus Forms, and you need the Lotus Forms Viewer to open it at all.
Then simply download. There is no charge, no sign-up and no email to hand over, and the file that arrives is exactly what the publisher released.
With the form signed, send it where AR 40-68 tells you to send it — usually to the office it names, or through your unit administrative channel, or straight into your own record, depending on why you raised it. Keep a copy for yourself before it leaves your hands. How long the receiving office holds it is not your decision or theirs; the records schedule for the series settles that, and local habit does not override it.
If you find you need a second form to go with this one, look by series and number. Forms in the DA series that share a proponent or a prescribing directive are often used together, and any form named on the face of this one normally goes forward with it. Gather continuation sheets, cover sheets and transmittal documents before you submit, not after somebody asks for them.
Check the edition date again the next time you reach for this form. Editions change when the proponent revises the content, and a copy you saved months ago may no longer be current — compare the date printed on your file against the edition in force before you type anything into it. What you do not need to do is redo work already finished: a form you completed and submitted under an earlier edition stays as it is.
Finally, know where you are. These are copies of published Department of the Army forms, made available for you to download. The site is independent, unconnected to the Department of the Army, and in no position to issue forms or to promise that any office will accept yours. None of this is legal advice. If a specific entry puzzles you, if you are unsure a requirement applies, or if eligibility is in question, put the question to TSG or to the administrative office serving your unit.
Questions and answers
- What is DA Form 5441-32?
- EVALUATION OF CLINICAL PRIVILEGES - DERMATOLOGY
- 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
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)