What is DA Form 5441-31? It is the Department of the Army form titled EVALUATION OF CLINICAL PRIVILEGES - CHIROPRACTIC, and it exists so that you can evaluation of clinical privileges - chiropractic. That single line covers most of what people arrive looking for. The rest of this page fills in the details.
Am I looking at the right edition? The copy here carries the date 02/01/2004 and the status ACTIVE. Forms in the DA series are identified by edition date rather than by revision number, so that date is what you compare against. One correction: a newer edition now exists. This one is superseded and remains available only for reference and for files already executed on it.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
What can I download here? The formats available are PDF, XFDL. Each one reproduces the identical official layout. What separates them is the method of entry, nothing on the page itself.
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.
Does the download cost anything? No. There is no charge, no account and no email address to surrender, and the file you receive is the published document with nothing added to it.
Where do you start? At the top of the page, with the identifying entries: name as your official records spell it, identification number, unit or organisation, date of preparation. Why first? Because those entries are what the form is filed and searched under later, and a record indexed on a misspelled name is a record nobody retrieves.
What is the fastest way to fill the body? Tab from field to field. The order was set at build time and normally matches how the page reads, which is why tabbing catches boxes that clicking past would leave empty. And the boxes and buttons? Those take a click. Where only one option in a set can apply, choosing one deselects the other.
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.
What does the Privacy Act notice tell you? The legal authority behind the collection, what the information is for, the routine uses it may be put to, and whether disclosure is compulsory. When is the right moment to read it? Before completing the personal entries, at the point the statement appears. What follows from it? Your finished copy contains personal data, so store and send it the way your office handles that category.
What happens after signing? The form is routed as the prescribing directive requires: to a named office, through the unit administrative channel, or into the personal file. Do you get the original back? No, so make a copy first. Who sets the retention period? The applicable records schedule, not the office holding the document.
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.
Why do editions change? Because the proponent revises the content, and the edition date printed on the page marks the result. How do you tell whether a stored copy is still current? Compare its printed date against the edition in force before you use it again. Does a new edition invalidate what you already filed? No. Records executed under a superseded edition stand as they are.
Is this an official Department of the Army site? No. It is an independent site distributing reproductions of published Department of the Army documents for download, with no authority to issue forms. Does it guarantee acceptance of anything you submit? It does not, and nothing on the page is legal advice. Who should you ask instead? TSG or your servicing administrative office, whenever an entry, a requirement or your eligibility is in doubt.
Questions and answers
- What is DA Form 5441-31?
- EVALUATION OF CLINICAL PRIVILEGES - CHIROPRACTIC
- 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)