What does this form do? DA Form 5440-35 is titled DELINEATION OF CLINICAL PRIVILEGES - PSYCHOLOGICAL ASSOCIATE, and its job is to delineation of clinical privileges - psychological associate. Anyone sent to find "the 5440-35" is being sent here. Everything below expands on that one function.
Is this the current version? The edition offered here is dated 02/01/2004, published with the status ACTIVE. That date is the version number of a military form; there is no other. And no, this is not the newest one. A later edition has been published, and this copy is kept only for reference and for records already completed on it.
Who fills it out, and how long does it take? The individual named in the entries fills it, or a records clerk fills it on that person's behalf. Length is 2 page(s) with about unknown entry fields, which is the honest measure of the work involved. Who owns the form and when it is raised comes from TSG and AR 40-68 respectively.
Download the form
Which formats can I download? These: PDF, XFDL. All of them carry the same published page — the difference is not what the form says but how you get words onto it.
What is the difference between fillable and printable? A fillable pdf has live fields that accept typing and can be saved with your entries in place. A printable pdf is the same blank page with no live fields, meant to come out of a printer and be completed with a pen. Both print identically once filled.
Which application should I use? Reading takes nothing beyond a browser. Filling takes a proper pdf reader, since browser viewers vary in whether they retain what you type — verify with a single field and a save before you fill the whole form. What is xfdl? The IBM Lotus Forms format used inside Army systems. It requires the Lotus Forms Viewer; nothing else opens it.
Do I have to sign up? No. Every format is free, no account is involved, and the file is distributed unmodified.
What goes in first? The heading block — your name exactly as official records show it, then identification number, then organisation, then the date you prepared the form. Is the order important? It is, because those four entries become the index for the finished record, and an error there is the one mistake that hides the document from everyone looking for it.
How do you move through the fields? By tab, not by mouse. The tab order was fixed when the form was built and generally follows the reading order of the page, so following it is the simplest way to avoid skipping a box. What about check boxes? Click them. If a group is exclusive, your new selection clears the old one — that is the design, not a malfunction.
What happens if your answer is too long for the field? It prints cut off. A single-line field does not wrap, so text running past the edge stays readable on screen and then disappears at the margin on paper. What do you do instead? Move it to the remarks area or onto a continuation sheet. And a field that does not apply to you? Mark it as not applicable rather than leaving it blank — an empty box tells the reviewer nothing about whether you read the question.
When do you sign? Last, after every other entry is settled. Until the signature is applied the document is a draft, however complete it looks. What if more than one signature is required? Reviewing official, approving authority and witness sign in the order the blocks print, and each dates the form on the day of signing rather than the day it was prepared. What goes wrong most often? Mandatory fields left empty, transposed digits in identification numbers, dates with day and month reversed, and old entries surviving in a working copy that was reused instead of a fresh blank form.
Why does the form carry a Privacy Act statement? Because personal information is being collected, and the statement declares the authority, the purpose, who else routinely sees the data, and whether answering is required or optional. Is it worth reading? Read it before you fill the fields it governs, not after. Does it change how you keep the file? It should — a filled copy is a personal record and gets the handling such records receive.
Where does the finished form go? Wherever AR 40-68 says — to the office it names, along your unit administrative channel, or into the individual's own record, depending on why it was raised. Should you keep a copy? Yes, before it leaves your hands. How long is it held? The records schedule for the series decides that, and local practice does not override it.
How do you find related forms? By series and number. Documents in the DA series sharing a proponent or a prescribing directive are commonly used together, and a form cited on the face of another usually goes forward with it. When should you gather them? Before submission — continuation sheets, cover sheets and transmittal documents belong in the package from the start.
When is an edition replaced? When the proponent revises the form and publishes a new edition date. What should you do with a copy kept on your own machine? Check its date against the edition in force before reusing it. Does the change reach backwards? It does not; work already completed on an earlier edition remains valid as filed.
Who publishes these files? This site does, as copies of published Department of the Army forms offered for download. Is there any official connection? None — the site is independent of the Department of the Army and issues nothing itself. Will a given office accept your document? That is not something anyone here can state, and none of this page is legal advice. Where do you take a specific question? To TSG, or to the administrative office that services your unit.
Questions and answers
- What is DA Form 5440-35?
- DELINEATION OF CLINICAL PRIVILEGES - PSYCHOLOGICAL ASSOCIATE
- 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)