Form/Template Mar 25, 2024 Assisted Reproductive Services for the Benefit of Seriously or Severely Ill/Injured (Category II or III) Active Duty Service Members: Qualifying Service Member Information and Attestation .PDF | 2.64 MB The DHA Form 407 as an attestation from the Service member of their intent to parent any child born as a result of the covered Assisted Reproductive Technology (ART) services they are seeking. It also serves to collect information that will allow the Managed Care Support Contractor to link a referral to Service members and any TRICARE-enrolled ... Recommended Content Women's Health Men's Health