(Currently AF Form 1540)

Time gaps of 30 days or more between periods of training, education, or employment must be explained in the "Remarks" section. A statement must be made to document the activities and location of the provider during the period, to include vacation, relocation activities, etc.

Applicants currently in training programs are required to supply updated DHA Form 367 and Clinical Privilege Lists no more than 45 days prior to completion of a training program.