AF Form 2816-2: Clinical Privileges for Air Force Physician – Physician Assistants (PAs) serving in the U.S. Air Force play a vital role in delivering high-quality healthcare to service members, families, and beneficiaries at military treatment facilities (MTFs). To practice independently or within defined scopes, they must obtain formal clinical privileges. The key document for this process is AF Form 2816-2, titled Clinical Privileges – Physician Assistant.
This article explains what AF Form 2816-2 is, its purpose, how to complete it, the types of privileges it covers, and the overall privileging process for Air Force Physician Assistants.
What Is AF Form 2816-2?
AF Form 2816-2 (also referred to as AF IMT 2816-2, dated 20020505) is the official Air Force form used to request, verify, and recommend approval of clinical privileges specifically for Physician Assistants. It defines the scope and limits of practice for an individual PA based on their credentials, training, experience, and demonstrated competence.
The form ensures that PAs provide care only within areas where they are fully qualified and where the facility can support the requested services. Privileges align with Air Force Medical Service (AFMS) standards and broader Department of Defense policies.
Official Download:
AF Form 2816-2 PDF
Purpose of the Form
The principal purpose of AF Form 2816-2 is to document and authorize the specific clinical activities a Physician Assistant may perform. This includes evaluation, diagnosis, treatment, procedures, and patient management across outpatient, inpatient, and procedural settings.
Privileges are granted based on:
- Education and training
- Certification (e.g., NCCPA)
- Licensure
- Relevant clinical experience
- Facility capabilities and support
- Recommendations from clinical supervisors
This process supports patient safety, quality care, and compliance with Title 10 U.S.C. Chapter 55, Sections 1094 and 1102. Information from the form may be shared with licensing boards, professional organizations, or civilian institutions when needed. Disclosure is voluntary, but failure to provide required details can limit or terminate privileges.
Structure of AF Form 2816-2
The form has two main parts:
Part I – Applicant/Privilege Request and Verification
- Applicant details: Name (Last, First, MI) and name of the medical facility.
- List of Clinical Privileges with columns for Requested and Verified codes.
- Applicant signs and dates the form.
Part II – Clinical Supervisor’s Recommendation
- The supervisor reviews the request and recommends: Approve, Approve with Modification (specify), or Disapprove (specify).
- Supervisor signs and dates, then forwards to the Credentials Function/Office.
Codes Used on the Form (entered in ink):
- 1 — Fully competent within the defined scope of practice.
- 2 — Supervision required (e.g., lacks current relevant experience or certification).
- 3 — Not approved due to lack of facility support (Credentials Function reserves this).
- 4 — Not requested/not approved (due to lack of expertise, proficiency, physical limitation, etc.).
Applicants enter Codes 1, 2, or 4 in the Requested column to reflect their current capability. The Clinical Supervisor or verifier uses the facility’s master privileges list to enter codes in the Verified column.
Specialty PAs (with AFSC shred-outs) must also complete the privilege list for their specific specialty in addition to the general PA form.
Core and Supplemental Privileges for Physician Assistants
AF Form 2816-2 organizes privileges into Core and Supplemental categories, covering outpatient care, inpatient care, and procedures.
A. Core Privileges
Outpatient:
- Assessment and management of common conditions in internal medicine, pediatrics, gynecology, family planning, prenatal care, and various surgical subspecialties (orthopedic, ENT, ophthalmology, urology).
- Physical exams, consultations, health education, specimen collection, temporary duty profiles, admissions/discharges, and Primary Care Manager (PCM) duties.
Inpatient:
- Admission of patients (after consultation), ongoing management, and assistance with uncomplicated surgical procedures.
Procedures:
- Life support (BLS, ACLS, ATLS), airway management (intubation), wound care, IV access, laceration repair, local anesthesia, abscess drainage, catheterization, foreign body removal, Pap smears, minor skin/subcutaneous surgeries, biopsies, nail removal, casting/splinting, skin lesion treatment, and basic eye exams (slit lamp, tonometry).
B. Supplemental Privileges
These are advanced or specialized services that require additional training or documentation, such as:
- Emergency department management
- Behavioral/psychosocial issues
- Specific dermatologic, gynecologic, or surgical procedures (e.g., IUD insertion, cryotherapy, central line placement, thoracentesis, fracture reduction, vasectomy, arthrocentesis, multi-layer laceration repair)
- Other procedures like lumbar puncture, stress testing, or sigmoidoscopy (in internal medicine contexts)
PAs can also request “Other” privileges (up to 4 items) by specifying them.
Modern Master Privilege Lists (MPLs) from the Air Force Medical Service further detail scopes for general PAs and specialties like Emergency Medicine, General Surgery, ENT, or Aeromedical PAs. These updated lists expand on the core form and should be referenced during completion.
How to Complete AF Form 2816-2?
- Obtain the facility’s current master privileges list.
- In Part I, mark your requested privileges using the appropriate codes. Be honest about your capabilities.
- Sign and date, then forward to your Clinical Supervisor.
- The supervisor reviews, verifies using the master list, and completes Part II with their recommendation.
- Submit to the MTF Credentials Office/Function for final processing.
Important: Any changes to approved privileges must follow AFI 44-119, Medical Quality Operations (or current DHA-aligned guidance). All entries must be made in ink.
New PAs (including recent IPAP graduates or direct commissions) typically work with the MTF Credentials Office to initiate the process, often through systems like JCCQAS, and provide supporting documentation (licenses, certifications, training records, etc.).
Broader Context: Air Force PA Credentialing and Privileging
Clinical privileging for Air Force PAs falls under the AFMS quality management framework. The process ensures providers meet rigorous standards for competence and that care aligns with MTF capabilities. It integrates with performance improvement, risk management, and patient safety programs.
Physician Assistants in the Air Force enjoy a broad scope of practice under physician supervision or collaboration, including primary care, acute care, procedural assistance, and deployment medicine. Privileges support autonomous decision-making within defined limits.
For the most current guidance, consult your local Credentials Office, the Air Force Medical Service Credentials Verification resources, or official publications on airforcemedicine.af.mil. Specialty-specific MPLs (e.g., PA-Emergency Medicine, PA-General Surgery) provide detailed privilege statements beyond the base AF Form 2816-2.
Why Proper Privileging Matters?
Accurate completion of AF Form 2816-2 protects patients, supports PA professional growth, and ensures compliance with federal regulations and DoD/Air Force policy. It allows qualified PAs to deliver essential care across clinics, hospitals, and operational environments while maintaining the highest standards of military medicine.
Need the form?
Download the latest official version directly from the Air Force e-Publishing site: AF Form 2816-2 PDF.
For questions about completing the form, required supporting documents, or specialty privileges, contact your MTF Credentials Office or refer to current AFI/DHA guidance on clinical quality management.
This guide is for informational purposes and is based on official Air Force forms and publications. Always verify with current directives and your local medical facility, as processes and master privilege lists may be updated.