AGFA NX Family of Systems (CR/DR) vNX27_A&I
Forms & Templates
On this page, you will find various forms that Military Health System uses to support its programs. Please scroll down the page or use the search box to find specific forms and templates.
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Recent Forms & Templates
Image Management Systems Dental Imaging and Infrastructure
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Jan. 1, 2024
Stryker AIRO Mobile CT Scanner A&I
.PDF |
741.76 KB
Stryker AIRO Mobile CT Scanner A&I privacy impact assessment
Form/Template
Jan. 1, 2024
Fuji ASPIRE Cristalle FDR 3000AWS
.PDF |
567.83 KB
Privacy impact assessment for the Fuji ASPIRE Cristalle AWS is a series of integrated FFDM combining X-Ray systems with a-SE detectors and an Acquisition Workstation (AWS). The ASPIRE Cristalle creates digital mammography images by direct capture of X-Ray using the a-SE detector.
Form/Template
Dec. 21, 2023
Business Intelligence Common Services
.PDF |
664.47 KB
Privacy impact assessment for the Business Intelligence Common Services serves as the Defense Health Agency Solutions Delivery Division Common Services environment for Data Analytics, Business Intelligence and Reporting requirements at the departmental and enterprise level.
Form/Template
Dec. 21, 2023
Diagnostica Stago STA Satellite System V6.x A&I
.PDF |
733.26 KB
Diagnostica Stago STA Satellite System V6.x A&I privacy impact assessment
Form/Template
Dec. 21, 2023
Assistance Reporting Tool
.PDF |
673.60 KB
Privacy impact assessment for the Assistance Reporting Tool is a secure web-based system that captures authorizations and feedback on TRICARE related benefits. Customer service personnel use ART to document beneficiary questions and concerns related to TRICARE and how those issues are resolved.
Form/Template
Dec. 18, 2023
Enterprise Patient Queuing and Notification System
.PDF |
564.01 KB
Privacy impact assessment for the Enterprise Patient Queuing Notification System automates patient check-in during visits to Military Treatment Facilities and clinics.
Form/Template
Dec. 18, 2023
DOD Drug Demand Reduction Program MedCOI
.PDF |
731.07 KB
Privacy impact assessment for the DOD-Drug Demand Reduction Program-MedCOI enclave is not part of an MTF, but consists of hardware, software, and telecommunications architecture to provide forensic drug testing to DOD commands located globally.
Form/Template
Dec. 4, 2023
RaySearch RayStation Radiation Therapy System
.PDF |
736.60 KB
Privacy Impact Assessment
Form/Template
Dec. 4, 2023
DelWorks DR Artpix Mobile EZ2GO
.PDF |
748.56 KB
Privacy impact assessment for the DelWorks DR ArtPix EZ2GO is a flexible high-resolution Digital Radiography (DR) system designed to provide fast and smooth radiography examinations of patient imaging.
Form/Template
Dec. 4, 2023
DHA E-Commerce System
.PDF |
642.38 KB
DHA E-Commerce System privacy impact assessment
Form/Template
Dec. 1, 2023
Protected Health Information Management Tool (PHIMT)
.PDF |
648.77 KB
Protected Health Information Management Tool privacy impact assessment
Form/Template
Dec. 1, 2023
Nuclear Medicine Information System Biodose
.PDF |
747.26 KB
Privacy impact assessment for the Nuclear Medicine Information System Biodose. NMIS is an application hosted on a Virtual Machine Windows 2019 server. NMIS is only used by Radiology, particularly in the Nuclear Medicine Division, Radiation Safety, and National Intrepid Center of Excellence Nuclear Medicine.
Form/Template
Dec. 1, 2023
Stryker Connected Operating Room Hub A&A
.PDF |
742.21 KB
Stryker Connected Operating Room Hub A&A privacy impact assessment
Form/Template
Dec. 1, 2023
Sysmex CS Win10 Series Hemostasis Analyzers A&I
.PDF |
558.85 KB
Sysmex CS Win10 Series Hemostasis Analyzers A&I privacy impact assessment
Form/Template
Dec. 1, 2023
MagView Mammography Information System
.PDF |
664.12 KB
Privacy impact assessment for the MagView Mammography Information System (MMIS) is a commercial-off-the-shelf (COTS) product. The Magview information software is an automated workflow efficiency tool used for mammography practice.
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