Interagency Comprehensive Plan for Care Coordination Support
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 five 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?
- Please visit the DHA Forms Management page on Inside DHA. CAC authentication is required.
- If you have questions, please send an email to the DHA Forms Management Office.
Having problems downloading a Form?
If you’re getting an error message when downloading a form, then try:
- Updating your Adobe Acrobat or Adobe Reader.
- Downloading the file using Microsoft Edge. Chrome, Firefox, and other browsers no longer support opening PDFs.
If that doesn’t work, right-click on the form you’re trying to download and select “save-as” to save the form to your computer.
Recent Forms & Templates
18th MDG Kadena AB MEDCOI
Surveillance Management and Reporting Tool
DHA Appointing Portal
Medical Department Activity-Bavaria
Soldier Performance Health and Readiness
Enterprise Mobile Platform of Innovation Ready Environments
IMS Dental
Centralized Credentials and Quality Assurance System
45th MDG Patrick AFB MEDCOI
Popular Forms & Templates
DHA-GL Worksheet 02: Pre-Authorization Request
Neurobehavioral Symptom Inventory Form
Interagency Comprehensive Plan for Care Coordination Support
Patient Global Impression Change Scale
DHA-GL Worksheet 01: Medical Eligibility Verification
18th MDG Kadena AB MEDCOI
Medical Readiness Decision Support System (MRDSS)
Surveillance Management and Reporting Tool
Financial Management Information System
Limited Duty Sailor and Marine Readiness Tracker MHS Application Access Gateways
We found 483 items
Medical Facility Directory: Use and Disclosure
This HIPAA Information Paper describes the Medical Facility Directory: Use and Disclosure (updated October 2024)
Best Practices for Disposing PHI
This HIPAA Information Paper describes the Best Practices for Disposing PHI (updated October 2024).
Info Paper Sending and Receiving PHI by Facsimile
The Department of Defense Manual DoDM 6025.18, Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in DoD Health Care Programs, requires that DoD covered entities have in place reasonable administrative, technical, and physical safeguards to protect the privacy of PHI.
Airborne Hazards and Open Burn Pit Registry Fact Sheet for Service Members
Service members and veterans who may have been exposed to airborne hazards, such as open burn pit smoke, while deployed could be at risk for short- and long-term health issues.
Airborne Hazards and Open Burn Pit Registry Frequently Asked Questions
The Department of Veterans Affairs developed the Airborne Hazards and Open Burn Pit Registry to better understand the potential health effects of exposure to airborne hazards during military service, support ongoing research, and inform future decisions around airborne hazards to keep service members and veterans healthy and safe.
Device and Media Controls (Updated October 2024)
This HIPAA Information Paper describes Device and Media Controls. Updated October 2024
Incidental Uses and Disclosures of PHI
This HIPAA Information Paper describes the Incidental Uses and Disclosures of Personal Health Information (updated September 2024).
Medical Simulation and Training PMO Brochure
The Medical Simulation and Training PMO serves as the materiel developer and total lifecycle systems manager for medical simulation and training products across the Military Health System.
Traumatic Brain Injury and Alcohol Misuse
This fact sheet describes how excessive drinking can impact service members with TBI. The fact sheet also provides resources for managing alcohol consumption.
Acute Concussion Care Pathway Fact Sheet for Providers
TBICoE developed this fact sheet on the acute concussion pathway to aid in standardized care. The fact sheet also includes details on reporting requirements in the deployed setting.
Pregnancy Postpartum Depression Infographic
information about depression during or after pregnancy, including perinatal depression “baby blues” , how to identify perinatal depression, what to do, how it can affect baby and family.
Pelvic Floor Muscle Training
This three page guide provides information on understanding the effects of pregnancy on pelvic floor muscles.
Medication Overuse Headache Following Concussion Fact Sheet
This fact sheet explains the basics of medication overuse headache as well as treatment and prevention strategies.
Managing Headaches Following Concussion Fact Sheet
This patient fact sheet on managing headache following concussion will help patients understand post-traumatic headache basics, triggers, and non-drug remedies. Post-traumatic headache is one of the most common and persistent symptoms of mild traumatic brain injury.
Pediatric to Adult Care Transition App
The PACT mobile application helps youth make the transition from pediatric to adult care by providing information and resources that allow them to take responsibility for their health care.
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.
You are leaving Health.mil View the external links disclaimer.