AF Form 1562: Credentials Evaluation Guide & PDF Download

AF Form 1562: Credentials Evaluation Guide & PDF Download – The AF Form 1562, officially titled Credentials Evaluation of Health Care Practitioners, is a key U.S. Air Force document used in the credentialing and privileging process for healthcare providers in the Air Force Medical Service (AFMS). It helps evaluate the professional qualifications, education, training, experience, and peer/supervisor assessments of physicians, nurses, dentists, and other licensed independent practitioners (LIPs) or allied health professionals seeking clinical privileges or assignments within Air Force facilities.

This form supports the rigorous standards required for safe, high-quality patient care in military treatment facilities (MTFs), clinics, and hospitals. It is frequently referenced alongside AF Form 1540 (Application for Clinical Privileges) and governed primarily by AFI 44-119, Medical Quality Operations (which aligns with DoD and DHA policies on credentialing).

Why AF Form 1562 Matters in the Air Force Credentialing Process?

The Air Force requires thorough primary source verification (PSV) and peer review to grant clinical privileges. AF Form 1562 collects structured evaluations from current supervisors and peers to assess a practitioner’s competence, professionalism, and fitness for duty.

Key purposes include:

  • Documenting professional background for privileging decisions.
  • Supporting initial appointment, renewal, or transfer of credentials.
  • Ensuring compliance with accreditation standards (e.g., The Joint Commission) and DoD policies like DHA-PM 6025.13 on clinical quality management.
  • Providing objective input on clinical performance, interpersonal skills, and any concerns regarding patient care or conduct.

Two AF Form 1562s are typically required for privileging applications: one from the applicant’s current clinical supervisor/medical director/chief and one from a current peer in the same specialty. These references must align with those listed on the AF Form 1540.

The form is part of a broader credentials file maintained in systems like the Centralized Credentials Quality Assurance System. It helps the Medical Staff Executive Committee or credentials committee make informed decisions about scope of practice and privileging.

Who Needs to Complete or Use AF Form 1562?

  • Healthcare practitioners applying for clinical privileges in Air Force MTFs (active duty, Reserve, Guard, or civilian providers).
  • Supervisors and peers providing evaluations (must be current and in relevant roles).
  • Credentialing offices at Air Force medical facilities for processing applications.
  • Program directors or evaluators in graduate medical education or training contexts.

It applies across the Total Force, though specific processes may vary slightly for Air Reserve Component (ARC) units.

How to Download the Official AF Form 1562?

The most current official version is available directly from the Air Force e-Publishing site:

→ Download AF Form 1562 PDF here: https://static.e-publishing.af.mil/production/1/af_sg/form/af1562/af1562.pdf

Always use the official PDF from e-Publishing.af.mil to ensure you have the latest revision. Third-party fillable templates exist but should be cross-checked against the authentic form for accuracy and compliance.

What Information Is Collected on AF Form 1562?

While the exact layout can vary slightly by revision, the form generally captures:

  • Applicant Information — Name, rank/grade, AFSC or specialty, SSN or DoD ID, contact details, current duty location.
  • Purpose of Evaluation — Initial credentials, renewal, transfer, or specific privileging request.
  • Professional History — Education, postgraduate training, certifications, licensure (state and DEA/controlled substance registration), board certification status, and prior experience.
  • Evaluator Sections — Ratings or narrative comments on:
    • Clinical competence and judgment.
    • Technical skills and procedural abilities.
    • Patient care quality and outcomes.
    • Communication and teamwork.
    • Professionalism, ethics, and adherence to standards.
    • Any adverse actions, malpractice history, or concerns.
  • Evaluator Certification — Signature, title, contact information, relationship to the applicant (supervisor/peer), and date.
  • Release/Authorization — The applicant typically authorizes release of information and may include a liability release statement.

The form emphasizes current, relevant references to ensure up-to-date assessments.

Tip for Completion: Be thorough, factual, and specific. Evaluators should base comments on direct observation. Incomplete or vague forms can delay processing.

Step-by-Step Guide to Filling Out and Submitting AF Form 1562

  1. Download the PDF from the official source linked above.
  2. Applicant Section — Fill in personal and professional details accurately.
  3. Identify Evaluators — Select one current supervisor and one current same-specialty peer. Ensure they are listed on your AF Form 1540 (if applicable).
  4. Provide the Form to Evaluators — They complete their assessment sections independently.
  5. Review and Sign — Applicant reviews for accuracy and signs any authorization/release blocks.
  6. Submit — Route through the local credentials office or as directed by your facility’s medical staff coordinator. Electronic submission via secure systems is common.
  7. Retain Copies — Keep records for your personal credentials file.

Processing times vary by facility and complexity but are part of the overall privileging timeline, which includes PSV of education, licensure, and National Practitioner Data Bank (NPDB) queries.

Note: All privileged providers must maintain active BLS (or higher) certification from AHA or Red Cross.

  • AF Form 1540 — Application for Clinical Privileges (often requires AF Form 1562 references).
  • AFI 44-119 — Medical Quality Operations (core guidance on credentialing, privileging, and quality management).
  • DHA-PM 6025.13 — Clinical Quality Management in the Military Health System, Volume 4: Credentialing and Privileging.
  • Other supporting forms: AF Form 494 (Academic/Clinical Evaluation Report), AF Form 2665 (for nurses), etc.

For full policy details, consult the latest versions on e-Publishing.af.mil or your local Medical Treatment Facility credentials manager.

Common Questions About AF Form 1562

Q: Is AF Form 1562 the same as a full credentials application?
A: No. It is one component focused on peer and supervisor evaluations. The full process includes multiple documents and verifications.

Q: Who can serve as an evaluator?
A: A current clinical supervisor/medical director and a current peer in the same specialty. They must have direct knowledge of the applicant’s performance.

Q: What if there are concerns noted on the form?
A: Any adverse information triggers additional review, potential peer review, or restrictions on privileges per AFI 44-119 and DoD policy.

Q: Does it apply to civilian contractors or only military members?
A: It is primarily for those seeking privileges in AFMS facilities, which can include certain civilians or contract providers.

Final Tips for Air Force Healthcare Providers

Maintaining a complete, current credentials file is essential for deployment readiness, assignments, and career progression in the AFMS. Work closely with your facility’s Credentials Coordinator or Medical Staff Office early in the process. Stay updated on revisions to forms and instructions via official Air Force channels.

For the most accurate guidance tailored to your situation, contact your local MTF credentials office or refer to current AFI 44-119 and DHA policies. Proper use of AF Form 1562 helps ensure the Air Force delivers exceptional medical care while protecting patients and providers alike.

This article is for informational purposes only and is based on publicly available U.S. Air Force publications and related guidance as of 2026. Always verify with official sources and your chain of command for current requirements.