Bio-Rad D-100 Hemoglobin Testing System v1.x_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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Popular Forms & Templates
Form/Template
Aug. 11, 2015
Coding and Compliance Editor (CCE)
.PDF |
166.39 KB
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Coding and Compliance Editor (CCE) system.
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Namenda XR
.DOCX |
32.18 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namenda XR
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Acne Isotretinoids
.DOCX |
34.54 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Acne Isotretinoids
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: GI-2 Agents, Miscellaneous
.DOCX |
33.03 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for GI-2 Agents, Miscellaneous
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Antirheumatics Injectable Methotrexate
.DOCX |
33.23 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Antirheumatics Injectable Methotrexate
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Namzaric
.DOCX |
31.83 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namzaric
Form/Template
Aug. 7, 2015
UFBPA Appendix for the Nov 2015 DOD P&T Meeting: ADHD Stimulants
.DOCX |
35.62 KB
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for ADHD Stimulants
Form/Template
July 28, 2015
PEPR Account Activation Request Form
.PDF |
6.81 MB
This form is required for all users to complete prior to receiving access to the Patient Encounter and Reporting (PEPR) application.
Form/Template
July 20, 2015
Audio Metric Database System (AUDBASE) 2.3
.PDF |
61.15 KB
This Air Force Medical Support Agency (AFMSA) Privacy Impact Assessment (PIA) summarizes the Audio Metric Database System (AUDBASE) 2.3 system.
Form/Template
July 20, 2015
STARS
.PDF |
58.44 KB
This Air Force Medical Support Agency (AFMSA) Privacy Impact Assessment (PIA) summarizes the STARS system.
Form/Template
June 29, 2015
Armed Forces Billing and Collection Utilization Solution (ABACUS)
.PDF |
178.10 KB
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Armed Forces Billing and Collection Utilization Solution (ABACUS) system.
Form/Template
May 20, 2015
Consent Checklist
.PDF |
106.87 KB
DOD Directive 3216.02 defines research involving a human being as an experimental subject as an activity, for research purposes, where there is an intervention or interaction with a human being for the primary purpose of obtaining data regarding the effect of the intervention or interaction. Examples of interventions or interactions include, but are ...
Form/Template
May 18, 2015
MHS IM-IT Submission Form
.DOCX |
284.45 KB
Fill out the MHS IM-IT Submission Form to submit an idea to foster change to an IM/IT capability, policy/process, or system.
Form/Template
May 1, 2015
Patient Global Impression Change Scale
.PDF |
59.99 KB
Form filled out by patients to rate their changes in activity, symptoms, emotions and quality of life.
Form/Template
April 30, 2015
Neurobehavioral Symptom Inventory Form
.PDF |
79.84 KB
Form used by providers to question patients about their symptoms
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