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Military Health System

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Change Healthcare Cyberattack Impact on MHS Pharmacy Operations. Read the statement to learn more. 

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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.

Please note that files more than two years old may not be compliant with Section 508 of the Rehabilitation Act. If you need an accessible version of a particular file, please contact us and we will provide one for you.

Looking for an official Defense Health Agency Form?

We found 231 items

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FOIA Document
May 6, 2015

TRICARE beneficiaries with a diagnosis of Parkinson's Disease

.PDF | 50.59 KB

Identify and validate other health insurance policies provided to non-duty services member beneficiaries to ensure TRICARE is a secondary payer to any applicable third party insurance and to assist the Services with maximizing their Third Party Collection Program revenues.

FOIA Document
May 6, 2015

Identification and Validation of Other Health Insurance

.PDF | 2.31 MB

Identify and validate other health insurance policies provided to non-duty services member beneficiaries to ensure TRICARE is a secondary payer to any applicable third party insurance and to assist the Services with maximizing their Third Party Collection Program revenues.

FOIA Document
May 6, 2015

Direct Care encounters for Multiple Sclerosis

.PDF | 87.13 KB

Identify and validate other health insurance policies provided to non-duty services member beneficiaries to ensure TRICARE is a secondary payer to any applicable third party insurance and to assist the Services with maximizing their Third Party Collection Program revenues.

FOIA Document
Oct 27, 2014

2008 Autism Spectrum Disorder - Age 21 and Younger

.PDF | 22.42 KB

Unduplicated total number of unique military beneficiaries age 21 and younger with a diagnosis of Autism Spectrum Disorder broken down by sponsor's duty status on December 31, 2008.

FOIA Document
Oct 27, 2014

CSA Program Performance Statement of Work - Fort Drum

.PDF | 123.78 KB

(Section J Attachment 10.1) Clinical Support Agreement (CSA) Program Performance Based Statement Of Work Behavioral Health Support Services For Guthrie Ambulatory Health Care Clinic, Fort Drum, New York

FOIA Document
Oct 27, 2014

2008 Focal Interventions for Autism Spectrum Disorder

.PDF | 1.78 MB

ECRI Institute Report; Focal Educational and Behavioral Interventions for the Treatment of Autism Spectrum Disorders (ASDs). Full In-Depth Health Care Technology Assessment (CLIN 3002) Contract No. H94002-05-D-0003 Task Order No. 28.

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