AF Form 3929: Clinical Privileges – Speech Pathologist (PDF)

AF Form 3929: Clinical Privileges – Speech Pathologist (PDF) – Speech-language pathologists (SLPs) serving in the U.S. Air Force play a vital role in diagnosing and treating communication, swallowing, and cognitive-communication disorders for service members, families, and other beneficiaries. AF Form 3929, titled Clinical Privileges – Speech Pathologist, is the official document used to request, verify, and grant these clinical privileges within Air Force Medical Treatment Facilities (MTFs).

This form ensures that SLPs practice within their demonstrated competencies, aligning with Air Force standards for quality care and patient safety.

What Is AF Form 3929?

AF Form 3929 is an official Air Force form that defines the scope of practice for individual speech pathologists. It lists specific clinical privileges in categories such as general practice, advanced privileges, related practices, and additional or facility-specific items.

Authority: Title 10, U.S.C. Chapter 55, Sections 1094 and 1102.
Principal Purpose: To evaluate credentials and performance to establish the scope and limits of an SLP’s practice.

Information on the form may be shared with licensing boards, professional organizations, or civilian institutions (e.g., during transitions from military service). Disclosure is voluntary, but incomplete information can limit or terminate privileges.

Key Sections and Privileges on AF Form 3929

Part I: List of Clinical Privileges

Applicants and supervisors use numeric codes:

  • 1 — Fully competent within defined scope of practice.
  • 2 — Supervision required (e.g., for those lacking current experience).
  • 3 — Not approved due to lack of facility support (supervisor use only).
  • 4 — Not requested/not approved (due to lack of expertise, proficiency, or physical limitations).

A. General Practice (Diagnostic and therapeutic management of):

  • Articulation/phonological disorders
  • Voice disorders
  • Fluency disorders
  • Pre-speech, pre-language, and language for infants and toddlers
  • Language for children, adolescents, and adults
  • Cognitive-communication assessment
  • Comprehensive speech-language pathology services

B. Advanced Privileges (includes):

  • Swallowing function (dysphagia)
  • Resonance and nasal airflow
  • Aural rehabilitation
  • Prosthetic/adaptive devices
  • Orofacial myofunctional disorders
  • Augmentative and alternative communication (AAC)
  • Treatment of central auditory processing disorders (in adults and children)

C. Related Practices:

  • Hearing screening
  • Consultation, prevention, counseling
  • Speech-language and communication instruction

D. Additional Privileges:

  • Referral to specialists
  • Product dispensing
  • Other facility-specific items (e.g., tracheoesophageal voice prosthesis, FEES, MBS studies, laryngeal endoscopy/stroboscopy in updated master privilege lists)

A more detailed DOD Master Privilege List (MPL) for Speech Language Pathology (updated as of 2022) expands on these with specific procedures like modified barium swallow studies, fiberoptic endoscopic evaluation of swallow (FEES), and voice analysis.

Who Uses AF Form 3929?

  • Active Duty, Reserve, and Guard speech pathologists (BSC officers or civilian equivalents).
  • Applicants for initial privileges, renewals, or updates.
  • Those transitioning to civilian practice (the form supports portability of credentials).

It is typically submitted with DHA Form 367 or AF Form 1540 (Application for Clinical Privileges/Medical Staff Appointment).

How to Complete AF Form 3929 (Step-by-Step)?

  1. Applicant: Fill in requested privileges using Codes 1, 2, or 4. Reflect your current capability—ignore facility limitations. Sign and date, then forward to your Clinical Supervisor. Use ink.
  2. Clinical Supervisor: Verify using the facility’s master privileges list. Enter codes (1-4) and recommend approval, approval with modifications, or disapproval. Sign and forward to the Credentials Function.

Important Notes:

  • Changes to privileges must follow AFI 44-119 (Medical Quality Operations).
  • Training program graduates: Submit forms no more than 45 days before completion. Program directors verify skills gained.
  • Privileges are facility-specific and based on training, experience, certification (e.g., ASHA CCC-SLP), and state licensure where applicable.

Why Clinical Privileging Matters in the Air Force?

Privileging protects patients and providers by ensuring SLPs deliver evidence-based care for conditions ranging from pediatric language delays to complex swallowing disorders in tracheostomy or laryngectomy patients. It supports mission readiness by maintaining high standards in military healthcare.

For Air Force SLPs, this process integrates with broader credentialing under AFI 44-119 and DoD policies, promoting portability of skills for future civilian careers.

Download AF Form 3929

Official PDF Download: AF Form 3929 – Clinical Privileges – Speech Pathologist

Related Resources:

  • Master Privilege List (Speech Language Pathology) – Air Force Medical Service site.
  • AFI 44-119 – Governing instruction for clinical privileges.

Tips for Air Force SLPs

  • Maintain current ASHA certification, state licensure (where required), and continuing education.
  • Document clinical hours, procedures, and outcomes for re-privileging.
  • Consult your MTF Credentials Office or AFCCVO for guidance on submissions.

Keywords: AF Form 3929 PDF, Air Force speech pathologist privileges, clinical privileges SLP military, AFI 44-119 speech pathology.

This article is for informational purposes only and is based on publicly available official U.S. Air Force and DoD sources as of the latest updates. Always verify with your local Credentials Function or the Air Force Medical Service for the most current requirements and forms.