Get the free DA FORM 5441-1, FEB 2004. Evaluation of Clinical Privileges - Dentistry - armypubs army
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EVALUATION OF CLINICAL PRIVILEGES DENTISTRY For use of this form, see AR 40-68; the proponent agency is OSG. 1. NAME OF PROVIDER (Last, First, MI) 2. RANK/GRADE 3. PERIOD OF EVALUATION (YYYYMMDD)
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What is da form 5441-1 feb?
DA Form 5441-1 Feb is a form used by the Department of the Army to report safety investigation findings and recommendations.
Who is required to file da form 5441-1 feb?
Military personnel and Department of the Army civilian employees are required to file DA Form 5441-1 Feb if they are involved in an accident or safety incident.
How to fill out da form 5441-1 feb?
To fill out DA Form 5441-1 Feb, you need to provide details such as the accident date and location, a description of the accident or incident, any injuries or damages caused, and any safety recommendations.
What is the purpose of da form 5441-1 feb?
The purpose of DA Form 5441-1 Feb is to document and report safety investigation findings and recommendations in order to improve overall safety in the Department of the Army.
What information must be reported on da form 5441-1 feb?
DA Form 5441-1 Feb requires reporting of information such as the accident date and location, a description of the accident or incident, any injuries or damages caused, and any safety recommendations.
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