Special Needs Program Management Information System
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
35th MDG Misawa AB MEDCOI
Online Base of Information Widely Accessible over Network
MHS GENESIS OC3 Electronic Health Record CORE
Navy Medicine Enterprise Web Services
Keller ACH - West Point MEDCOI
Nutrition Management Information System
Automated Neuropsychological Assessment Metrics Military Performance Database
Anatomic Pathology Laboratory Information System
375th MDG Scott AFB MEDCOI
Popular Forms & Templates
DHA-GL Worksheet 02: Pre-Authorization Request
Neurobehavioral Symptom Inventory Form
Patient Global Impression Change Scale
DHA-GL Worksheet 01: Medical Eligibility Verification
Medical Readiness Decision Support System (MRDSS)
Limited Duty Sailor and Marine Readiness Tracker MHS Application Access Gateways
Financial Management Information System
CS SCE 2875
DHA-GL Worksheet 03: Formal Appeal Request
Palmetto Government Benefits Administrator (PGBA)
We found 484 items
How Thinking Affects Sleep
A fact sheet discussing how your thoughts can affect quality of sleep
Conflict Resolution
A fact sheet describing the strategies that can help vetrans communicate with families and friends while facing the challenges of returning from deploymnent.
Health Plan Identifier and Other Entity Identifier Fact Sheet
This fact sheet explains the Health Plan Identifier and Other Entity Identifiers
Proposed Health Care Clinical Attachments
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Section 1173(a)(2)(B)) identified electronic “Health Care Claims Attachments” as a transaction for which a standard was to be adopted. A proposed rule was published in 2005, but a final rule was never published due to questions about the maturity of the standards being ...
DMRTI Training Support Request
Form to request training support from the Defense Medical Readiness Training Institute.
Formulary Management for Weight Loss Agents
Formulary Management for Weight Loss Agents
MHS VLER HIE eHealth Exchange Partners
This document lists the private sector health care partners that the Military Health System can currently share information with.
Amputation Care Equipment Requirements
This fact sheet describes equipment needs for amputees based on level and number of amputations.
VHA TRAIN
VHA TRAIN is an external learning management system to provide valuable, Veteran-focused, accredited, continuing medical education at no cost to community health care providers.
DHA-PGI 224: Protection of Privacy and Freedom of Information
Personally Identifiable Information (PII), Protected Health Information (PHI), and Federal Information Requirements
The Defense Medical Epidemiology Database System Overview Fact Sheet
This fact sheet provides a system overview of the Defense Medical Epidemiology Database (DMED). DMED is a web-based tool to remotely query de-identified active component personnel and medical event data contained within the Defense Medical Surveillance System (DMSS). Learn about the newly released version of DMED and its key features in this document.
Osseointegration
This fact sheet provides information on osseointegration (OI) and the use of this procedure for the direct skeletal attachment of prosthetic limbs in Military Health System (MHS) beneficiaries with amputations.
HIPAA Operating Rules
The Department of Health and Human Services (HHS) establishes a single set of operating rules for each Health Insurance Portability and Accountability Act (HIPAA) transaction and promulgate rules to establish its adoption. Operating Rules affect TRICARE where it employs HIPAA electronic transactions in Private Sector Care as a Health Plan/Payer and in ...
HIPAA Electronic Funds Transfer and Remittance Advice Fact Sheet
TRICARE Managed Care Support Contractors (MCSCs), acting as a health plan/payer, are required to accommodate and be compliant with the transactions for Health Care Electronic Funds Transfers (EFTs) and Remittance Advice (RA). These standards intended to streamline the format and data content of transmissions a health plan sends to its bank when it ...
Demographic and Military Traits of Service Members Diagnosed as Traumatic Brain Injury Cases
This fact sheet provides details on the demographic and military traits of service members diagnosed as traumatic brain injury (TBI) cases during a 16-year surveillance period from 2001 through 2016, a total of 276,858 active component service members received first-time diagnoses of TBI - a structural alteration of the brain or physiological ...
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.