AF Form 2820-2: Women’s Health NP Clinical Privileges

AF Form 2820-2: Women’s Health NP Clinical Privileges – AF Form 2820-2: Clinical Privileges – Women’s Health Nurse Practitioner is the official U.S. Air Force form used to request, verify, and grant clinical privileges to Women’s Health Nurse Practitioners (WHNPs) practicing in Air Force medical facilities.

This two-page form (AF IMT 2820-2, dated 20020505, V1) standardizes the delineation of privileges based on the provider’s education, training, experience, and demonstrated competence. It ensures safe, high-quality care for female service members, dependents, and other beneficiaries within the Air Force Medical Service (AFMS).

What Is AF Form 2820-2 Used For?

The primary purpose of AF Form 2820-2 is to define the scope and limits of practice for individual Women’s Health Nurse Practitioners. Privileges are granted only after a thorough evaluation of credentials and performance, as required by Title 10, U.S.C. Chapter 55, Sections 1094 and 1102.

Key features:

  • Applicant indicates requested privileges using specific codes.
  • Clinical Supervisor verifies competence and recommends approval (or modifications).
  • The form supports credentialing processes governed by AFI 44-119 (Clinical Performance Standards and Privileging).

Information from the form may be shared with licensing boards, professional organizations, or civilian facilities when the provider transitions out of the Air Force.

Download the official form here: AF Form 2820-2 PDF

Who Uses AF Form 2820-2?

This form is primarily for:

  • Active Duty, Reserve, and National Guard Women’s Health Nurse Practitioners in the Air Force.
  • Advanced Practice Registered Nurses (APRNs) specializing in women’s health/obstetrics-gynecology care.
  • Providers seeking initial appointment, renewal, or modification of privileges at Air Force medical treatment facilities (MTFs).

Women’s Health Nurse Practitioners deliver comprehensive primary and specialty care focused on reproductive health, prenatal/postpartum care, gynecologic services, family planning, and preventive health for women across the lifespan.

Structure of AF Form 2820-2

The form includes sections for:

  1. Applicant and Facility Information (name, medical facility).
  2. Part I: Requested and Verified Privileges — Divided into Core Privileges, Procedures, and Other.
  3. Part II: Clinical Supervisor’s Recommendation (approve, approve with modifications, or disapprove).
  4. Signatures from the applicant and clinical supervisor (all entries must be made in ink).

Coding System:

  • Applicant (Requested): Uses codes 1, 2, or 4 to reflect current personal capability (without regard to facility limitations).
  • Clinical Supervisor (Verified): Uses codes 1, 2, 3, or 4 based on the facility’s master privileges list and direct assessment.

Code Meanings:

  • 1 — Fully competent within defined scope of practice.
  • 2 — Supervision required.
  • 3 — Not approved due to lack of facility support (supervisor only).
  • 4 — Not requested/not approved (due to lack of expertise, proficiency, physical limitation, etc.).

Core Privileges (Section A)

Core privileges for Women’s Health Nurse Practitioners typically include:

  1. Taking, evaluating, and recording health histories.
  2. Performing physical examinations for health status and acute/chronic problems.
  3. Ordering laboratory studies, X-rays, EKGs, and other diagnostics.
  4. Collecting specimens, including Pap smears.
  5. Analyzing data, formulating problem lists, and developing treatment plans. 6–8. Performing initial obstetric visits, routine prenatal follow-up, and postpartum follow-up.
  6. Conducting orientation classes.
  7. Performing routine yearly asymptomatic gynecological examinations.
  8. Initiating consultations and referrals.
  9. Issuing temporary profiles (up to 30 days, with limitations).
  10. Admitting/discharging patients to quarters (up to 72 hours with physician concurrence).
  11. Diagnosing, treating, and managing acute/chronic illnesses and behavioral issues.
  12. Counseling on medical problems, medications, diet, and health maintenance.
  13. Conducting health maintenance briefings for newly assigned active duty females.
  14. Providing health maintenance for well patients.
  15. Managing common gynecological and obstetrical problems.
  16. Family planning counseling and services (oral contraceptives, Depo-Provera, diaphragms, IUD insertion/removal). 20–21. Counseling on sexual/marital problems and unwanted pregnancies.
  17. Educating groups on pregnancy, childbirth, family planning, newborn care, etc.
  18. Prescribing pharmacological agents, including Schedule II-V controlled substances (within scope).
  19. Performing infertility evaluations.
  20. Assisting in surgery as necessary.

Specific Procedures (Section B)

WHNPs may request privileges for hands-on procedures such as:

  • Endocervical curettage
  • Endometrial and cervical biopsies
  • IUD insertion and removal
  • Diaphragm fitting
  • Cryosurgery
  • Incision and drainage of Bartholin cysts
  • Excision/biopsy of vulvar lesions
  • Colposcopy
  • Norplant insertion/removal (older reference; modern equivalents apply)
  • Punch, excisional, or shave biopsies
  • Local infiltration anesthesia
  • Needle aspiration for culture

Additional “Other” privileges can be requested in Section C as needed.

How to Complete AF Form 2820-2?

For the Applicant:

  • Enter the appropriate code (1, 2, or 4) for each requested privilege.
  • Sign and date the form.
  • Forward it to your Clinical Supervisor.

For the Clinical Supervisor:

  • Review credentials and performance against the facility master list.
  • Enter verified codes (1–4).
  • Recommend approval status in Part II.
  • Sign and forward to the Credentials Function.

Changes to approved privileges must follow AFI 44-119 procedures. Clinical oversight requirements for advanced practice providers are also outlined in that instruction.

Importance in Air Force Medicine

Proper use of AF Form 2820-2 supports quality patient care, risk management, and compliance with federal standards. It allows qualified WHNPs to practice to the full extent of their training while maintaining appropriate supervision and facility resource alignment.

Women’s Health Nurse Practitioners play a critical role in the Military Health System by providing accessible, specialized care that improves readiness and health outcomes for women in uniform and their families.

Note: Always use the most current version of the form available on the official e-Publishing site (e-publishing.af.mil). Requirements and specific privilege lists may be supplemented by Department of Defense or Air Force Medical Service guidance, including master privilege lists generated from systems like CCQAS.

For credentialing questions, contact your local Medical Treatment Facility Credentials Office or refer to AFI 44-119.

Keywords: AF Form 2820-2, Women’s Health Nurse Practitioner privileges, Air Force clinical privileges, WHNP Air Force, AFMS credentialing, military nurse practitioner form.

This article is for informational purposes only and is based on the official form and publicly available Air Force guidance. Consult official directives and your chain of command for current policy.