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Use DA Form 5440-51 when you need to delineation of clinical privileges - neurosurgery. Full title: DELINEATION OF CLINICAL PRIVILEGES - NEUROSURGERY. Everything you need is on this page — the file, the entry rules, the routing. Edition 02/01/2004, status ACTIVE, 3 page(s), roughly unknown fields. Note the supersession: a later edition exists, and this one applies only to records already completed on it.
Authority sits in two places. TSG owns the form, AR 40-68 says when it is raised and where it goes. Routine cases need neither read in full — the page itself carries the sequence. The entries are completed by their subject or by unit administrative staff working from what that person supplies.
PDF, XFDL are available and the decision takes one second. Type your entries: fillable pdf. Write them: printable pdf. The published layout is common to both, so the format governs your method and nothing more.
Use a full pdf reader, not the browser viewer. Browser viewers display fields they cannot always save, and the loss shows up only when you reopen the file — type one entry, save, reopen, verify, then fill the rest. The xfdl file is IBM Lotus Forms, used inside Army systems, and opens in the Lotus Forms Viewer alone — no pdf reader, no word processor.
Nothing is charged and no sign-up applies. Files are served as published, without changes to the page image.
Start at the top and get the header exactly right. Official spelling of the name, identification number, unit, date. Everything downstream finds the record through those entries; nothing else on the page has that consequence.
Tab through the fields rather than clicking. The tab order was fixed when the form was built and generally follows the page, which catches boxes a mouse skips past. Check boxes and option buttons take a click, and an exclusive group clears the previous selection when you make a new one. Single-line fields do not wrap — text past the field width prints truncated while still showing in full on screen, which is why the loss is discovered after printing. Overflow goes to remarks or a continuation sheet. A field that does not apply gets the mark meaning none; blank space reads as an omission.
Signature comes after every other entry — ink or an approved electronic means, and without it the document is a draft. Where reviewing, approving or witnessing signatures are called for, take them in printed block order, each dated on the day applied. Before release, one pass from the top. The defects worth hunting are always the same four: mandatory fields left empty, identification digits transposed, dates with day and month reversed, and stale data surviving in a copy reused in place of a blank form.
Read the Privacy Act statement at the point it appears. Authority, purpose, routine uses, mandatory or voluntary — four facts, and they govern what you are about to enter. A completed copy holds personal data and takes the handling rules that attach to it.
Routing follows AR 40-68 and nothing else — a named office, the unit administrative channel, or the individual's file, according to why the form was raised. Copy it before it leaves. Retention is fixed by the records schedule for the series, which local practice does not shorten or extend.
Look for associated forms by series and number. In the DA series, documents sharing a proponent or a governing directive tend to travel together, and anything referenced on the page normally submits alongside. Collect continuations, covers and transmittals in advance of sending.
Edition date is the version number, printed on the page. Hold a locally saved copy against the current edition before reuse, since nothing on your machine signals a revision. Work already executed under a superseded edition remains as filed.
These are reproductions of published Department of the Army documents, offered for download. The site is independent, connected to nothing official, and issues no forms of its own. Nothing here is legal advice and no statement is made about acceptance by any office. Questions about an entry, a requirement or eligibility go to TSG or your servicing administrative office.
Questions and answers
- What is DA Form 5440-51?
- DELINEATION OF CLINICAL PRIVILEGES - NEUROSURGERY
- 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),