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Military Health 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 two 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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AFMES Form 25: Histology Request and Specimen Storage

Form/Template
6/10/2021

Use this form to obtain information/specimens needed for histology tissue processing and/or specimen storage.

Recommended Content:

Armed Forces Medical Examiner System | Forensic Pathology Investigations (FPI) | Repository of Specimen Samples for the Identification of Remains | DNA Identification Laboratory

AFMES Form 3: Autopsy Request

Form/Template
6/9/2021

Use this form to request for an autopsy report and supplemental information

Request for Autopsy Report and Supplemental Information

Form/Template
6/9/2021

Use this form to obtain records/reports/photos of remains by persons legally authorized access to this information.

TCCC ASM CM Student Registration Form

Form/Template
4/7/2021

Students must complete this form to register for the course. All forms are emailed to the DMRTI TCCC Section for processing.

Recommended Content:

Health Readiness & Combat Support | Defense Medical Readiness Training Institute | DMRTI Course Information | Tactical Combat Casualty Care Course (TCCC)

Freezer Temperature Log - Fahrenheit

Form/Template
3/25/2021

Temperature log for freezers storing vaccines, with form for recording vaccine storage troubleshooting.

Recommended Content:

Vaccine Storage and Handling

Refrigerator Temperature Log - Fahrenheit

Form/Template
3/25/2021

Temperature log for refrigerators storing vaccines, with form for recording vaccine storage troubleshooting.

Recommended Content:

Vaccine Storage and Handling

Freezer Temperature Log - Celsius

Form/Template
3/25/2021

Temperature log for freezers storing vaccines, with form for recording vaccine storage troubleshooting.

Recommended Content:

Vaccine Storage and Handling

Refrigerator Temperature Log - Celsius

Form/Template
3/25/2021

Temperature log for refrigerators storing vaccines, with form for recording vaccine storage troubleshooting.

Recommended Content:

Vaccine Storage and Handling

DHA Form 207: COVID-19 Vaccine Screening and Immunization Document, v23

Form/Template
3/25/2021

The purpose of this form is to determine if the COVID-19 vaccine can be administered to the patient. (v23, Oct. 2022)

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts | Coronavirus and the COVID-19 Vaccine | COVID-19 Information for Military Treatment Facility Directors

Emergency Vaccine Retrieval and Storage Plan Worksheet

Form/Template
3/24/2021

Recommended Content:

Vaccine Storage and Handling | Potential Vaccine Compromise Reporting

Sample WISDOM Agenda 5 Day

Form/Template
2/11/2021

Recommended Content:

M2 Functional Specifications | MDR, M2, ICDs Functional Support

aCME Disclosure FY20 Fillable

Form/Template
1/29/2021

Instructor CME Disclosure form

Recommended Content:

Defense Medical Readiness Training Institute | DMRTI Course Information | Emergency War Surgery Course (EWSC)

Research Repository Template

Form/Template
1/20/2021

The RRT asks researchers whether they intend to put data into a repository, and if yes, what data and under what governance terms.

Recommended Content:

Privacy and Civil Liberties

EWSC Student Enrollment Form

Form/Template
1/8/2021

Fillable student enrollment form for EWSC registration.

JOP Nomination Form

Form/Template
11/24/2020

Student/nominee JOP course request form.

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Last Updated: July 19, 2022
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