AF Form 2823: Clinical Privileges Dermatologist – Download – AF Form 2823 is the official U.S. Air Force form used to request, delineate, and grant clinical privileges specifically for Dermatologists practicing in Air Force Medical Treatment Facilities (MTFs). It ensures that board-certified or board-eligible dermatologists meet rigorous credentialing standards before providing independent or supervised care for skin, hair, nail, and mucous membrane conditions.
What Is AF Form 2823 Used For?
The form documents a dermatologist’s requested scope of practice, including core privileges and any special or procedure-specific privileges. It supports the formal credentialing and privileging process governed primarily by AFI 44-119 (Medical Quality Operations) and aligned Defense Health Agency (DHA) policies.
Key purposes include:
- Evaluating qualifications for medical staff appointment and clinical practice in Air Force facilities.
- Defining the range of dermatologic services a provider can deliver (e.g., medical dermatology, procedural dermatology, or laser treatments).
- Ensuring patient safety through standardized review of training, board certification, experience, and competency.
- Supporting initial appointment, renewal (typically every 2 years), and modifications to privileges.
Dermatologists in the Air Force diagnose and treat a wide variety of conditions affecting active duty members, dependents, and retirees. Privileges allow them to manage common issues like acne, eczema, psoriasis, skin cancer screenings, and perform biopsies, excisions, and other office-based procedures.
Who Needs to Complete AF Form 2823?
- Active Duty Air Force dermatologists
- Civilian or contract dermatologists seeking privileges at an MTF
- Residents or fellows transitioning to independent practice (with appropriate supervision levels noted)
- Providers requesting privilege renewal or expansion
The form is typically completed alongside DHA Form 367 (or equivalent) and submitted through the local Credentials Function or the Air Force Clinical Credentials Verification Office (AFCCVO).
Key Sections of AF Form 2823
While the exact layout follows standard Air Force privileging forms, AF Form 2823 generally includes:
- Provider Information — Name, rank/grade, specialty (Dermatology), facility, and personal identifiers.
- Education, Training, and Certification — Medical school, residency in dermatology (ACGME or equivalent), board certification status (American Board of Dermatology), and any fellowships.
- Core Privileges — Standard dermatology services such as:
- Evaluation, diagnosis, and non-surgical treatment of skin, hair, and nail disorders.
- Skin biopsies (shave, punch, incisional).
- Excisional procedures for benign and malignant lesions.
- Cryotherapy, electrosurgery, and intralesional injections.
- Management of dermatologic emergencies.
- Special/Procedure-Specific Privileges — These may require additional documentation of training and proctoring, such as:
- Mohs micrographic surgery
- Laser therapy (various wavelengths)
- Phototherapy (PUVA, UVB)
- Cosmetic procedures (if authorized at the MTF)
- Inpatient consultative services or ICU/operating room care per local policy
- Supervision Levels — Codes indicating whether privileges are requested as fully independent (code 1), with oversight, or not requested.
- Certification and Signatures — Provider attestation, supervisor/program director recommendations, and approval by the privileging authority (often the MTF Commander or designated official).
Important Note: Dermatologists may admit patients and provide care in higher-acuity settings only in accordance with specific MTF policies.
How to Download the Official AF Form 2823?
Official PDF Download:
AF Form 2823 – Clinical Privileges – Dermatologist
Always use the most current version from the official Air Force e-Publishing site. Forms are updated periodically to align with DHA and DoD standards.
Related Resources:
- Air Force Clinical Privileges List for Dermatology (DODMPL PHY DERM) – available on the Air Force Medical Service website.
- AFI 44-119 – Medical Quality Operations (governs the entire credentialing process).
The Air Force Dermatologist Credentialing Process (2025–2026 Overview)
- Application — Submit completed AF Form 2823 with supporting documents (CV, licenses, board certificates, training verifications, malpractice history, etc.).
- Primary Source Verification (PSV) — Performed by the Credentials Office.
- Department/Committee Review — Peer review by dermatology or medical staff.
- Privileging Authority Approval — Final signature by the designated official.
- Periodic Review — Privileges are time-limited and require renewal with evidence of ongoing competency, continuing medical education (CME), and quality data.
The process emphasizes evidence-based competency rather than solely years of experience. Providers in training must submit updated forms close to graduation (no more than 45 days prior in many cases).
Why Proper Completion Matters?
Accurate and timely completion of AF Form 2823 directly impacts:
- Ability to provide care without delays
- Compliance with Joint Commission, DHA, and Air Force standards
- Risk management and patient safety
- Career progression for military dermatologists
Incomplete or outdated submissions can delay onboarding or result in returned packets.
Tips for Completing AF Form 2823
- Use black ink or type entries.
- Request only privileges supported by your documented training and experience.
- Clearly indicate requested supervision levels.
- Attach any required proctoring or case logs for special procedures.
- Consult your local MTF Credentials Manager or the AFCCVO for specialty-specific guidance.
For the most current Dermatology privilege list, visit the official Air Force Medicine Credentials Verification Office page under Physicians forms.
Need Help with AF Form 2823 or Air Force Dermatology Career?
U.S. Air Force dermatologists enjoy a unique practice environment that combines clinical excellence, leadership opportunities, and service to the nation. Whether you are a board-certified dermatologist considering military service or already serving and navigating the privileging process, understanding AF Form 2823 is essential.
Official Sources (always verify for latest versions):
- Air Force e-Publishing (forms and publications)
- Air Force Medical Service – Credentials Verification Office
- DHA Procedural Manuals on Clinical Quality Management
This article is for informational purposes only and is based on publicly available U.S. Air Force and DHA guidance. Policies can change; always consult your local Credentials Function or official military channels for personalized guidance and the most current forms.
Primary Keywords: AF Form 2823, Clinical Privileges Dermatologist, Air Force dermatology privileges, AFI 44-119, download AF 2823, Air Force MTF credentialing.
Related Searches: Air Force dermatologist career, military dermatology privileges, DODMPL Dermatology, Air Force medical staff appointment.
Download your copy of AF Form 2823 today and ensure your privileges are current for providing high-quality dermatologic care to America’s warfighters and their families.