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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TRICARE Online (TOL) is a Department of Defense (DoD) Online Patient Portal (PP) which provides eligible beneficiaries with the following: access to Military Treatment Facilities' (MTFs) appointments, new prescription (Rx) fill and refills, health record data, service separation/retirement information as well as access to secure messaging (SM), and the Nurse Advice Line (NAL).
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Centralized Credentials Quality Assurance System (CCQAS) system.
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This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Assistance Reporting Tool (ART) system.
The Consolidated Information Center (CIC) Data Warehouse is used to facilitate the Bureau of Medicine and Surgery's analytical capabilities across Navy Medicine to improve speed of decision making.
The Armed Forces Billing and Collection Utilization Solution (ABACUS) provides a standard patient accounting system for health care billing practices.
3D Bio CAD 3 Shape TRIOS 3 (“TRIOS 3”) Wireless Scanner captures digital images of the teeth used to design and fabricate dental appliances.
The DHA Appointing Portal is a locally developed web application system used to automate vaccine availability and appointment scheduling. It is an enterprise-wide system currently hosted at Madigan Army Medical Center and accessible through a Defense Health Agency (DHA) website.
HIV Management Service (HMS) is a Private web-based information management system, owned, operated and maintained by the Navy Bloodborne Infection Management Center, used to conduct infectious disease-related administrative reporting, patient tracking, and allows Infectious Disease on-line transaction processing (OLTP) to access, validate, and conduct statistical analysis.
LIMDU SMART provides Navy and Marine Corps with real-time visibility of all personnel on limited duty status, capability to run reports on all aspects of Limited Duty (LIMDU) Program, and electronically manage process workflows.
7Ex is a single purpose programmable instrument that edges high base lenses using the 7Ex's unique cutter design. Performs drilling and grooving in one process with the flexibility to process all bevel cutting types.
The purpose of the Veterinary Services Systems Management (VSSM) system via the Remote Online Veterinary Record (ROVR) application is to record and maintain complete health care information to include treatment history and deployment status on all Government Owned Animals (GOA).
Medical Readiness Decision Support System (MRDSS) is an automated information system on the Global Information Grid (GIG) used by the Air Force Medical Services (AFMS) to manage readiness information in direct support of active Air Force units, Air National Guard, and Air Force Reserves, at fixed bases, and deployed locations during both peace and wartime operations
This form is used to determine if the COVID-19 vaccine can be administered to the pediatric patient. (Version 7, March 2022)
The DHA Form 46 is used to document a patient’s surgical care and ensure that care adhered to the Military Health System’s surgical and procedural safety protocols.
DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101
The appearance of hyperlinks does not constitute endorsement by the Defense Health Agency 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.