Begin by matching the form to your task. DA Form 5441-54 is titled EVALUATION OF CLINICAL PRIVILEGES - THORACIC SURGERY, and you reach for it when you need to evaluation of clinical privileges - thoracic surgery. Once that matches, check the date. The edition here is 02/01/2004, published with the status ACTIVE. After that, glance at the length: you will be working through 2 page(s) and somewhere near unknown fields. Check this before anything else — a more recent edition is out. Stay on this one only if the record you are handling was 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.
Now for the body. Use tab to advance through the fields; the order was set when the form was built and following it keeps you from leaving gaps. Check boxes and option buttons take a click. Where the options are mutually exclusive, choosing one will clear another, which is how the group is meant to behave. As you type longer entries, watch the field edge. One-line fields do not wrap, and anything past the edge prints missing even when you can still read it on screen — when that happens, put the text in remarks or on a continuation sheet. Leave nothing blank because it does not apply; enter the mark that means it does not apply, so the reviewer knows you read the question.
Sign at the end and not before. Use ink or the electronic method your office accepts; whatever the state of the entries, an unsigned form is still a draft. When a reviewer, approver or witness has to sign as well, collect those signatures in printed block order and make sure each one is dated the day it was applied, not the day you started. Then read the form through once from the beginning. Three faults account for most rejections: a required field left blank, an identification number with two digits swapped, and a date whose day and month are reversed. Add a fourth if you began from an old working copy — data left over from the last time will travel forward untouched.
At some point while filling the form you will meet a Privacy Act statement, and you should read it when you reach it rather than after you finish. It tells you who is authorised to collect the information, what it will be used for, who else may see it, and whether you are obliged to answer or may decline. Once you have entered your details, treat the file accordingly: it now holds personal information about you, so store it and send it the way your office handles such records.
Download the form
Then choose a file to download. What you will see offered is PDF, XFDL, and the only question you need to answer is whether you are typing or writing. Type, and you want the fillable pdf, where the entry areas respond to your keyboard. Write, and you want the printable pdf, which you print empty and complete with a pen. The layout does not change between them, so pick whichever fits how you plan to work today.
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.
One last point before you move on: every format is free. No registration stands between you and the file, and what you download is the published form, unaltered.
Once you have signed, route the form. The prescribing directive names the destination: an office, your unit administrative channel, or your personal file, according to the case. Make yourself a copy first, because you will not get the original back. After that, retention is out of your hands — the applicable records schedule fixes how long the document is kept, whatever the practice in a particular office.
Should the package need more than one document, search by series and number. Within the DA series, forms under the same proponent or the same prescribing directive tend to be required as a set, and a form referenced on the page you are filling usually accompanies it. Collect the continuations, covers and transmittals up front so the submission goes complete the first time.
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 5441-54?
- EVALUATION OF CLINICAL PRIVILEGES - THORACIC SURGERY
- 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),