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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.
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We found 467 items
This form is used to determine if the COVID-19 vaccine can be administered to the pediatric patient. (Version 13, October 2023)
When transporting vaccine off-site, you must log their storage temperature every hour to ensure they are kept at the required temperature range for the duration of the event.
When transporting vaccine off-site, you must log their storage temperature every hour to ensure they are kept at the required temperature range for the duration of the event.
When transporting vaccine off-site, you must log their storage temperature every hour to ensure they are kept at the required temperature range for the duration of the event.
TSMP collectively refers to: vaccines, some pharmaceuticals, temperature sensitive laboratory supplies, and other temperature sensitive medical items.
A form for screening both children and adults for contraindications to receiving influenza vaccine. (v5, August 2023)
Provides guidance on how to maintain vaccine storage requirements during an emergency.
340b Verification Form to be completed by the manufacturer and pharmacy for any 340b claim disputes.
Revised DSA Form - DSA Data Requests Templates Quick Reference Guide
Use this updated template to provide the de-identification process to be used for your project. The plan should show how MHS sensitive data elements (or quasi-identifiers) will be de-identified as well as how the 18 HIPAA identifiers will be handled.
Armed Forces Medical Examiner System Form 42-R, Evidence Chain of Custody.
Privacy Impact Assessment, 72nd Medical Group (MDG) Tinker Air Force Base (AFB) Medical Community of Interest (MEDCOI).
Privacy Impact Assessment, 81st Medical Group (MDG) Keesler Air Force Base (AFB) Medical Community of Interest (MEDCOI).
Imagine Dental Workstation WIN10 AI Privacy Impact Assessment, March 2023.
Privacy Impact Assessment, Clinical Information System (CIS) -.mil Enclave.
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