What is DA Form 5441-36? It is the Department of the Army form titled EVALUATION OF CLINICAL PRIVILEGES - AUDIOLOGY, and it exists so that you can evaluation of clinical privileges - audiology. 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 This one is superseded and remains available only for reference and for files already executed on it.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 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
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.
Should I take the fillable pdf or the printable one? Take the fillable version if you will type, since its entry areas respond to the keyboard and hold what you enter. Take the printable version if you will write by hand — it is the same blank form as a flat page image. The finished result looks the same either way.
Do I need special software? Not for reading — a pdf opens in the browser you already have. For filling, install a full pdf reader rather than trusting the in-browser viewer, which sometimes displays fields it cannot save. Type into one field, save, reopen and confirm the text survived. Why will my xfdl file not open? Because it is IBM Lotus Forms, not pdf. The Lotus Forms Viewer is the only application that reads it.
Is it free? Yes, entirely. No registration stands between you and the file, and what arrives is exactly what the publisher released.
Which entries come before the rest? The identifying ones at the head of the page: name, identification number, unit, date of preparation. Does it matter that they come first? Yes — everything downstream retrieves the record by those values, so they are worth getting right before you touch the substantive blocks.
How should you work through the entry fields? With the tab key. It follows the order the form was constructed in, which is usually the order the page reads, so nothing gets passed over. Do check boxes work the same way? They are clicked rather than tabbed into. In an exclusive group, a second click elsewhere clears your first choice, as intended.
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.
Is a signature really the last step? Yes, and without it you have a draft, not a form. Who else signs? Whoever the form calls for — reviewer, approver, witness — in printed block order, each dated as of the day they sign. Which errors cause the most returns? Blank mandatory fields lead, followed by identification numbers with two digits swapped, dates written day-for-month, and leftover data in a reused file that goes forward as though it were meant.
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.
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.
What if this form is not the only one you need? 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 anything named on the face of one normally accompanies it. Are continuations part of that? They are, along with covers and transmittals, and all of them are collected in advance rather than after a query.
What causes a form to be superseded? A revision issued by the proponent, after which the previous edition date no longer matches the one in force. How do you check a copy you saved? Read the edition date on the page and hold it against the current edition. Must earlier submissions be redone? They must not — a completed record executed on a prior edition is unaffected.
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 5441-36?
- EVALUATION OF CLINICAL PRIVILEGES - AUDIOLOGY
- 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)