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DELINEATION OF CLINICAL PRIVILEGES BEHAVIORAL HEALTH PRACTITIONER 1. NAME OF PROVIDER (Last, First, MI) For use of this form, see AR 40-68; the proponent agency is OSG. 2. RANK/GRADE 3. FACILITY INSTRUCTIONS:
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What is delineation of clinical privileges?
Delineation of clinical privileges is the process by which a healthcare organization grants specific clinical activities or procedures to a healthcare provider based on their qualifications and training.
Who is required to file delineation of clinical privileges?
All healthcare providers who work in a healthcare organization and wish to perform specific clinical activities or procedures are required to file delineation of clinical privileges.
How to fill out delineation of clinical privileges?
Healthcare providers must complete a delineation of clinical privileges form provided by the healthcare organization, providing information about their qualifications, training, and experience in specific clinical activities or procedures.
What is the purpose of delineation of clinical privileges?
The purpose of delineation of clinical privileges is to ensure that healthcare providers are qualified to perform specific clinical activities or procedures, thereby ensuring patient safety and quality of care.
What information must be reported on delineation of clinical privileges?
Healthcare providers must report their education, training, experience, licensure, board certifications, and any additional qualifications relevant to the specific clinical activities or procedures they wish to perform.
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