AF Form 2819: Clinical Privileges – Anesthesiologist (2026)

AF Form 2819: Clinical Privileges – Anesthesiologist (2026) – AF Form 2819 is the official U.S. Air Force form used to request, verify, and grant clinical privileges to anesthesiologists practicing in Air Force Medical Treatment Facilities (MTFs). It ensures that only qualified physicians provide perioperative care, anesthesia services, pain management, and related critical care in accordance with federal law and Department of Defense/Air Force standards.

Download the current official AF Form 2819 directly from the Air Force e-Publishing site: https://static.e-publishing.af.mil/production/1/af_sg/form/af2819/af2819.pdf.

What Is AF Form 2819 Used For?

The form documents the scope of practice for board-certified or board-eligible anesthesiologists in the Air Force Medical Service (AFMS). It aligns with Title 10, U.S.C. Chapter 55, Sections 1094 and 1102, which govern the credentialing and privileging of healthcare providers in military treatment facilities.

Key purposes include:

  • Requesting core and special clinical privileges based on the provider’s training, experience, and current competency.
  • Allowing clinical supervisors to verify requested privileges against the facility’s capabilities.
  • Supporting the formal credentials committee review and approval process.
  • Maintaining patient safety and compliance with AFI 44-119 (Clinical Performance Improvement and related credentialing policies).

Privileges are not automatic—they are granted based on evaluation of education, residency/fellowship training, board certification (typically by the American Board of Anesthesiology), current licensure, and recent clinical experience.

Who Uses AF Form 2819?

  • Active Duty, Reserve, and Guard anesthesiologists (MD or DO) assigned to or applying for privileges at Air Force MTFs.
  • Civilian anesthesiologists working under contract or as GS employees in Air Force facilities.
  • Credentialing offices, clinical supervisors, and the MTF Credentials Function for processing and renewal.

A related form, AF Form 2819-1, exists specifically for Certified Registered Nurse Anesthetists (CRNAs).

Structure of AF Form 2819

The form typically includes several parts:

Part I – Applicant Section
The anesthesiologist requests privileges by entering codes next to each listed procedure or category:

  • Code 1: Fully competent within defined scope of practice.
  • Code 2: Supervision required.
  • Code 4: Not requested / not approved due to lack of expertise or proficiency.

Applicants must sign and date the form, then forward it to their clinical supervisor.

Part II – Clinical Supervisor / Verifier Section
Supervisors review and verify privileges using similar codes, considering:

  • Facility support and resources (Code 3 may be used if the MTF lacks equipment or support for a procedure).
  • Provider’s documented performance and training.

The supervisor recommends approval, approval with modifications, or disapproval, then forwards the package to the Credentials Office.

Additional Sections usually cover:

  • Provider demographics and identifying information.
  • Specific privilege categories (core privileges and special/additional procedures).
  • Notes on changes to privileges and references to the local facility master privilege list.

Typical Clinical Privileges for Anesthesiologists (DOD MPL Anesthesiology)

The Department of Defense Master Privilege List (DOD MPL) for Anesthesiology (updated as of June 2023) defines the scope. Core privileges generally include:

  • Preoperative, intraoperative, and postoperative evaluation and management.
  • Administration of general, regional, and local anesthesia, plus all levels of sedation.
  • Support of life functions and vital organs during anesthetic, surgical, and other procedures.
  • Acute and chronic pain management and consultation (including patient-controlled analgesia, intrathecal, and epidural techniques).
  • Care in the intensive care setting (in accordance with MTF policies).
  • Assessment, stabilization, and disposition of patients with emergent conditions.
  • Basic echocardiography (including TEE probe insertion in some cases).

Common specific procedures listed on privilege forms include:

  • Various nerve blocks and regional anesthesia techniques.
  • Epidural blood patch.
  • Trigger point injections.
  • Airway management procedures (e.g., endotracheal intubation).
  • Sedation for procedures outside the operating room.

Special or advanced privileges (e.g., complex cardiac anesthesia, pediatric anesthesia subspecialty, or advanced pain interventions) require additional documentation of training and experience.

Privileges are facility-specific. Some procedures may not be granted if the MTF lacks the necessary equipment, support staff, or case volume.

The Credentialing and Privileging Process in the Air Force

  1. Application — Provider completes AF Form 2819 (and supporting documents such as DHA Form 367 where required).
  2. Primary Source Verification (PSV) — Credentials office verifies education, training, licensure, board certification, malpractice history, and references per AFI 44-119.
  3. Department/Service Chief Review — Clinical supervisor verifies requested privileges.
  4. Credentials Committee / Function Review — Multidisciplinary review and recommendation.
  5. Commander Approval — Final granting authority rests with the MTF Commander or designated official.
  6. Periodic Review — Privileges are typically reviewed every two years (biennial re-privileging), with ongoing monitoring through Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).

Any changes to approved privileges must follow service-specific policy.

Why Proper Completion of AF Form 2819 Matters

Accurate completion protects patients, supports high-quality perioperative care across Air Force facilities, and ensures compliance with Joint Commission, DoD, and Air Force standards. Incomplete or improperly coded forms are often returned for correction, delaying onboarding or renewal.

For providers transitioning from civilian practice or completing residency, the form helps translate prior experience into authorized military practice.

How to Access and Use the Form?

  • Official Download: AF Form 2819 PDF from e-Publishing.af.mil.
  • Always use the latest version available on the official Air Force publications site.
  • Consult your local MTF Credentials Office or the Air Force Medical Service Credentials Verification Office for guidance on completing the form alongside the current DOD MPL for Anesthesiology.
  • Related policy: AFI 44-119 (Clinical Performance Improvement).

Note: Requirements and privilege lists can be updated. Always verify the most current guidance through official Air Force Medical Service channels or your facility’s credentialing staff.

Need Help with AF Form 2819 or Anesthesiology Privileging?

If you are an anesthesiologist preparing for assignment to an Air Force base, renewing privileges, or supporting the credentialing process, contact your MTF Credentials Office early. They can provide the facility-specific master privilege list and answer questions about documentation requirements.

This form is a critical part of ensuring the highest standards of anesthesia care for service members, their families, and other beneficiaries in the Military Health System.

This article is for informational purposes only and is based on publicly available U.S. Air Force and DoD resources. Official guidance should always come from e-Publishing.af.mil and your local credentialing authority.