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.
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Recent Forms & Templates
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Online Base of Information Widely Accessible over Network
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Popular Forms & Templates
DHA-GL Worksheet 02: Pre-Authorization Request
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CS SCE 2875
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We found 484 items
Habit Transfer, Safety Checklist Mowing Lawn
Protect your hearing both on and off duty. Hat, Sunscreen, Shoes, Glasses, Hearing protection. It’s a noisy world. Protect your hearing both on and off duty.
Habit Transfer, Safety Checklist Riding Motorcycle
HELMET, GLOVES & JACKET, BOOTS, GLASSES, HEARING PROTECTION. It’s a noisy world. Protect your hearing both on and off duty.
Habit Transfer, Safety Checklist Riding Motorcycle
Friends. Band t-shirt. Tickers. Cellphone. Hearing Protection. It’s a noisy world. Protect your hearing both on and off duty
Habit Transfer, Gun Range
It’s a noisy world. Protect your hearing both on and off duty and at the gun range.
Don't Limit Your Future
Hearing loss can impact your next career. Wear hearing protection both on and off duty
Hearing Loss is Not Part of the Job
Service member focused: Hearing Loss is not part of the job. With proper protection, hearing loss is preventable
Military K9 Hearing Protection
You protect their hearing. Remember to protect yours
Process Overview for Referrals for Amputation Care
This document outlines the steps needed to refer a patient for amputation care.
Brandon Act Fact Sheet
DOD issued guidance on May 5, 2023, to establish policy, assign responsibilities, and provide procedures for service members to initiate a referral for a mental health evaluation.
ESSENCE Fact Sheet
The Department of Defense Electronic Surveillance System for the Early Notification of Community-based Epidemics collects near real-time biosurveillance data globally for over 9.5 million beneficiaries. ESSENCE receives several types of data, including outpatient health encounter records, pharmacy prescriptions, laboratory results, and radiology reports.
Blast Overpressure Provider Support Tool
The "Blast Overpressure Provider Support Tool" contains key information about blast overpressure (high and low-level blast), symptoms associated with BOP exposure, and the steps to address BOP exposure—documentation, symptom management, and coding. It also includes details on the occupational specialties and weapon systems that can increase risk of ...
What You Should Know About Blast Overpressure Fact Sheet
TBICoE developed this fact sheet for service members to learn more about blast overpressure, low-level blast, and high-level blast exposures and what possible effects those exposures can have on their brain health. Service members should be aware of the potential effects of blast exposures, which occupations and heavy weapon systems are associated ...
Airborne Hazards and Open Burn Pit Registry: Quick Tips for Providers
This fact sheet serves as a quick reference guide providing information (i.e., diagnostic codes, deployment and exposure considerations, and specialty referrals) that would be helpful to have on hand in an “easy-to-use” abbreviated format when evaluating patients with environmental exposure concerns.
Joint Trauma and Education Training Delivery Platform
JTETDP, commonly referred to as Deployed Medicine, delivers standardized medical readiness training across the Department of Defense and partner nations via a web-based application. The platform offers instruction in Tactical Combat Casualty Care, ensuring both active duty and reserve personnel are trained, ready, and capable of treating injured ...
Defense Health Agency Texting Solution
DHATS is a Communications as a Service platform that offers secure text messaging (Short Message Service) and delivery services for tenant applications.
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