Deployed Medicine
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 five 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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Recent Forms & Templates
374th MDG Yokota AB MEDCOI
Defense Medical Logistics - Enterprise Solution Core
Defense Medical Logistics - Enterprise Solution Amazon Web Services
Bliss AHC - Ft Huachuca MEDCOI
Expeditionary Medical Encounter Database
Naval Health Clinic Corpus Christi MEDCOI
Army Public Health Center LAN
Philips IntelliVue Information Center iX 4.x_AA
Andrews MDG JB Andrews MEDCOI
Popular Forms & Templates
Web MEDCASE Requirements and Execution 1.x AA 2990
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DHA-GL Worksheet 02: Pre-Authorization Request
Patient Global Impression Change Scale
DHA-GL Worksheet 01: Medical Eligibility Verification
Limited Duty Sailor and Marine Readiness Tracker MHS Application Access Gateways
Medical Readiness Decision Support System (MRDSS)
Financial Management Information System
TBI Caregiver Support Forms
Heidelberg Eye Explorer HEYEX 2
We found 492 items
HCE 805 Some of the Deepest Wounds Are Invisible
Some of the Deepest Wounds are Invisible. Arm your ears. Guard against permanent disability and safeguard sounds you cherish. Wear hearing protection.
Don't Be The Weak Link
Don’t be the weak link. Failure to wear hearing protection puts you, your unit, and your mission in danger.
Research and Program Assessment Data - Current Clinical Practice for Tinnitus - 2021 Survey Results All Providers
Operational performance and quality of life can be impacted by tinnitus, which is the #1 service-connected disability. A multi-disciplinary approach is key to managing patients with bothersome tinnitus. For this Quality Improvement Project, the team sent out the Understanding Practices of Tinnitus Collaborative Survey (UPTiCS) to VA and DoD providers ...
Clinical Practice Recommendation and Resource Tinnitus Care and Referral
This practice recommendation was initially created for primary care providers, but can be used by any clinician who sees patients with tinnitus. It is a summary of clinical practice guidelines and recommendations for tinnitus. The information provided in the document helps clinicians talk with patients about various types of tinnitus and deter-mine ...
CAVRN Map
Graphic representation of the USA locations of the members that represent the CAVRN Network.
Audiology Processing Disorder Factsheet
AUDITORY PROCESSING DISORDER: What Is It? Auditory processing disorder can be defined as “a condition in which people have trouble making sense of the sounds around them.” (National Institutes of Health)
Research and Program Assessment Data - VA & DOD Clinician Perspectives - PTM Clinician Handbook
The PTM Clinician Handbook was published in 2010, and updates are needed. VA and DoD audiologists and mental health providers were interviewed to understand how to best update the PTM materials.
CPG DOEHRS HC Tinnitus Question
The DOEHRS-HC Tinnitus Question information sheet was created to educate and guide DoD Hearing Conservation Technicians about tinnitus and correct recording in the DOEHRS-HC system
Research and Program Assessment Data -VA & DOD Clinician Perspectives - PTM Patient Workbook
The PTM Patient Workbook was published in 2010, and updates are needed. VA and DoD clinicians (from audiology and mental health) were interviewed to understand how to best update the PTM materials.
Medical Facility Directory: Use and Disclosure
This HIPAA Information Paper describes the Medical Facility Directory: Use and Disclosure (updated October 2024)
Best Practices for Disposing PHI
This HIPAA Information Paper describes the Best Practices for Disposing PHI (updated October 2024).
Info Paper Sending and Receiving PHI by Facsimile
The Department of Defense Manual DoDM 6025.18, Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in DoD Health Care Programs, requires that DoD covered entities have in place reasonable administrative, technical, and physical safeguards to protect the privacy of PHI.
Airborne Hazards and Open Burn Pit Registry Fact Sheet for Service Members
Service members and veterans who may have been exposed to airborne hazards, such as open burn pit smoke, while deployed could be at risk for short- and long-term health issues.
Airborne Hazards and Open Burn Pit Registry Frequently Asked Questions
The Department of Veterans Affairs developed the Airborne Hazards and Open Burn Pit Registry to better understand the potential health effects of exposure to airborne hazards during military service, support ongoing research, and inform future decisions around airborne hazards to keep service members and veterans healthy and safe.
Device and Media Controls (Updated October 2024)
This HIPAA Information Paper describes Device and Media Controls. Updated October 2024
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