Renewal staff 2025

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4.8 out of 5

42 votes

The document is the U.S. DOD Form dod-da-4691-1, which serves as an application for the renewal of clinical privileges and staff appointment for military and civilian healthcare providers. It outlines the necessary personal and professional information required to support credentialing processes, including education, licensure, certifications, and requested clinical privileges. The form emphasizes the importance of accurate information for timely processing and includes sections for provider identification, professional education, licensure details, and a declaration of competency.

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Versions	Form popularity	Fillable & printable
2004	4.8 Satisfied (42 Votes)

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