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Effective Health IT Reduces Burnout, Improves Patient Care
Information technology and its intersection with military health care was at the forefront of a key discussion at the annual Healthcare Information and Management Systems Society conference, held in Chicago, Illinois, from April 17 to 21.
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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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This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Delta Dental Federal Government Programs Information System (DDFGP-IS) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Defense Medical Human Resources System - Internet (DMHRSi) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Designated Provider Health Care Delivery System (DPHCDS) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the KARL STORZ Integrated Operating Room (i-OR) System with LiveData system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the United Concordia Companies Inc. (UCCI) Active Duty Dental Program (ADDP) system.
This template is used to track plans of action and milestones regarding potential breaches.
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Use this form to bill for cosmetic surgery.
Defense Health Agency - Great Lakes Worksheet (DHA-GL Worksheet-03) Complete this form when submitting a formal appeal for denied medical claims or denied pre-authorization requests by the DHA, Great Lakes.
Used to obtain information/specimens needed to evaluate and document forensic DNA testing.
The Data Request Template for Access by Login for all DHA Systems is required for a Data Sharing Agreement Application.
The Data Request Template for General Extractions is required for a Data Sharing Agreement Application.
Instructions for completing the MHS IM-IT Submissions Form. The form is used to submit an idea that fosters a change to an IM/IT capability, policy/process, or system.
Defense Health Agency (DHA) Office of Small Business Programs (OSBP) uses the System for Award Management (SAM), as well as other government-wide procurement systems, such as the Federal Procurement Data Systems (FPDS), to compile data on Small Business (SB) vendors. The information gathered assists in identifying vendors, their capabilities, and other information necessary for potential contracting opportunities with DHA. The below information captures such information and is used only to assist within the identification process. Completing and submitting this form is voluntary. DHA does not guarantee that your company will be selected for, or awarded a contract to provide products or services.
The Researcher Responsibilities Form ensures that all investigators conducting Department of Defense (DOD) research involving human participants understand and comply with all the relevant federal and DOD regulations, including Human Protections, records management, and the Health Insurance Portability and Accountability Act (HIPAA). The form also includes provisions related to any DOD biomedical research to comply with FDA regulations.
Form used to request access to the collections at the National Museum of Health and Medicine.
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.