What does this form do? DA Form 5441-35 is titled EVALUATION OF CLINICAL PRIVILEGES - PSYCHOLOGICAL ASSOCIATE, and its job is to evaluation of clinical privileges - psychological associate. Anyone sent to find "the 5441-35" is being sent here. Everything below expands on that one function.
Which edition is on this page? The one dated 02/01/2004, status ACTIVE. On army forms the edition date is the version, printed on the page itself so any copy can be checked. Be aware that a more recent edition has since been issued. This version is superseded and stays here for reference and for records already filled out on it.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 1 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.
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.
Can a field hold a long answer? Not if it is sized for one line — there is no wrap, and the excess prints missing while remaining visible as you type. So where does the extra text belong? In the remarks area or a continuation sheet. Should you skip fields that are irrelevant to your case? No. Mark them accordingly, because an empty field reads as an oversight rather than an answer.
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 is the Privacy Act statement on the page? A notice appearing wherever personal information is collected, setting out the authority for the collection, the purpose, the routine uses, and whether your disclosure is mandatory or voluntary. When should you read it? At the point you reach it, before entering the details it covers. And afterwards? Your completed copy holds personal data and is stored and transmitted under the rules that apply to such records.
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.
What exactly is this site? A place to download reproductions of published Department of the Army documents. Is it part of the Department of the Army? No — it is independent, issues no forms of its own, and has no authority over any of them. Can it tell you whether your completed form will be accepted? It cannot, and nothing written here is legal advice. Who answers the real questions? TSG or the administrative office servicing your unit, on any question of entry, requirement or eligibility.
Questions and answers
- What is DA Form 5441-35?
- EVALUATION 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
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA