The HIPAA Safeguard Review of Non-Federal Systems (HSR) is used when data obtained through a DSAA will be stored, transmitted, processed, or otherwise maintained on a non-federal information system.

Military Health System Data Repository (MDR) Special Justification Form. MDR Users will use this to request access to special tables in the MDR.

Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

Form for users to fill out to request information/data from EACE

Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

Please attach MTF P&T Committee comments & meeting minutes, an explanation of the rationale for the request, copies of supporting clinical evidence, and anything else that needs to be considered by the DOD P&T Committee.

To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.

This process guides references how to submit Discharge Summary notification from Inpatient or Outpatient Medical Care at a VA Facility under DOD/VA Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.

This process guides references how to submit Request for Durable Medical Equipment for Pre- Authorization of Inpatient or Outpatient Medical Care at a VA Facility under DOD/VA Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.