The reason DA Form 5440-52 looks the way it does is that a file has to speak for itself. Officially DELINEATION OF CLINICAL PRIVILEGES - CRITICAL CARE MEDICINE, it serves to delineation of clinical privileges - critical care medicine, and the record it produces outlasts the people and the circumstances behind it. Edition 02/01/2004, status ACTIVE, is the version published here: 2 page(s), close to unknown fields, each one present because some later reader will need that fact without being able to ask for it. Because a subsequent edition has appeared, this copy stays available — a record made under one edition is interpreted under that edition.
Behind any Army form sit two separate decisions. What the document asks is settled by TSG, which maintains and revises it. Whether you raise it, and where it goes once signed, is settled by AR 40-68. That division is the reason a form can outlive several changes in the process it serves.
The heading blocks come first because the record is retrieved by them, not read into. Name as official records spell it, identification number, unit, date of preparation — those four are the index, and everything below them is content that only surfaces once the index has done its work. A form filed under a name written casually is not lost in principle, only in practice, which amounts to the same thing.
Much of the form's behaviour follows from its being a fixed page. Tab order was set at build time along the reading sequence, which is why tabbing catches boxes a pointer passes over. Exclusive groups release one choice when another is made because a record cannot carry two answers to a single question. Single-line fields refuse to wrap because every entry must print where the layout expects it — text beyond the width is lost at the margin, visible on screen to the end. That is what remarks areas and continuation sheets are for. Marking a field that does not apply matters for a related reason: emptiness is ambiguous, and a reviewer reading the file later cannot distinguish an omission from a decision.
Signing is the act that makes the document evidence, and until it happens the entries are only a proposal. Additional signatures — reviewer, approver, witness — each stand for a separate judgement, dated when applied so the record shows who accepted what and in what order. The common faults all damage that record in the same way: a blank mandatory field breaks the chain of required answers, swapped digits in an identification number detach the document from its subject, an inverted day and month misplaces it in time, and stale data from a reused copy states things nobody meant to state.
Behind the Privacy Act statement is a requirement that anyone asked for personal data be told, in advance, under what authority it is sought, for what purpose, who else routinely sees it, and whether refusal is possible. Reading it after completing the fields defeats its function. And the completed form is itself a personal record from that point on, subject to the handling rules such records carry.
Download the form
Formats exist because completion happens under different conditions, not because anyone wanted variety. The published set is PDF, XFDL. A fillable pdf carries live entry objects, so typed text lands in fixed positions and stays legible whoever reads it later. A printable pdf drops those objects and leaves the page as an image, which is what an office needs where a screen is unavailable and a pen is not. The document itself is unchanged between them; what differs is the circumstance each anticipates.
Where a file opens matters more than it appears to. A browser will display a pdf, but browser viewers were built to read documents, and some accept keystrokes into fields they never intended to store — the entries are gone at tab close, without warning, because saving was never part of what that viewer does. A dedicated reader is built around the file's own structure and keeps what you enter. The xfdl file belongs to a different lineage entirely: IBM Lotus Forms, adopted across Army systems for the routing and signature handling built into it. That is why only the Lotus Forms Viewer reads it.
There is no charge and no sign-up. Published documents are distributed as published, without modification.
Where the signed form goes is settled by AR 40-68 rather than by the office holding it — a named recipient, the unit administrative channel, or the individual's own file, depending on why it was raised. Retention likewise belongs to the records schedule for the series, which exists so documents are kept for as long as anyone might need them and no longer. Keep a copy before release; the original serves the file from then on, not you.
Series and number are how the DA series signals which documents belong together, and the grouping follows real process boundaries: a shared proponent or directive usually means a shared purpose. A form cited on the face of another is part of that same transaction, and continuation sheets, covers and transmittals complete it.
Revision follows the process, which is why editions appear without a fixed interval, and the printed date rather than any version number identifies them. Nothing on a stored copy signals that it has aged; the check is manual. Work already completed under a superseded edition stands as filed, because the record was made under those terms and is properly interpreted under them.
One boundary should be stated clearly. What is distributed here are copies of published Department of the Army forms; the site is independent, issues nothing of its own, and holds no position in the system it describes. Proponency, prescribing directives and retention schedules operate without reference to it. Consequently nothing here is legal advice and no assurance about acceptance is possible. Questions about a particular entry, a requirement or eligibility belong with TSG or your servicing administrative office.
Questions and answers
- What is DA Form 5440-52?
- DELINEATION OF CLINICAL PRIVILEGES - CRITICAL CARE MEDICINE
- 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,