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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- Please visit the DHA Forms Management page on Inside DHA. CAC authentication is required.
- If you have questions, please send an email to the DHA Forms Management Office.
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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
Neurobehavioral Symptom Inventory Form
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
Medication Adherence App
The Medication Adherence application creates a tracker for patients to input their medication types, dosages, delivery methods, days, and times for taking medications. The app will set reminders and keep track of dosages taken and missed. The app also provides resources regarding medications and conditions.
Chronic Traumatic Encephalopathy (CTE) Frequently Asked Questions
This fact sheet provides answers and information to commonly asked questions about chronic traumatic encephalopathy, or CTE.
Pregnancy, Childcare & Parenting
2 sided handout – addresses some concerns that may be commonly encountered by those persons with upper limb amputation during pregnancy and early parenting.
Within Reach
The Rehabilitation Journey After Upper Limb Amputation – Book – 103-page book with 8 sections – 1. Rehabilitation journey 2. Coping with Amputation 3. Pain Management 4. Care of Residual Limb 5. Physical Rehabilitation 6. Functional Rehabilitation 7. The Prosthesis 8. Resources
What You Should Know About Concussions Fact Sheet
This fact sheet is designed to educate deployed service members about traumatic brain injuries immediately after concussion injury.
Healthy Sleep Following Concussion/mTBI Fact Sheet
Getting restful sleep is one of the most important things you can do for your health, and it often takes thoughtful preparation during the day. This fact sheet offers service members and veterans who experience sleep disturbances after a concussion with healthy sleep tips that can likely improve sleep.
FAQs for Reproductive Health Care
Frequently Asked Questions about reproductive health care. TRICARE has coverage for both medical and pharmacy benefits and includes a list of covered and non-covered services.
JHIE Partner List
Federal Joint HIE Total Partner List Oct. 28, 2022
Best Practices for Safeguarding Laptops
This HIPAA Information Paper describes the Best Practices for Safeguarding Laptops (updated October 2022).
Access Controls
This HIPAA Information Paper describes Person or Entity Authentication For Access Controls (Updated March 2015).
Administrative Safeguards
This HIPAA Information Paper describes Administrative Safeguards.
Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet
The Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet, developed by TBICoE, is a one page document that gives primary care managers (PCMs) an overview of neuroendocrine dysfunction (NED) that can occur after concussion, or mild TBI. It highlights conditions with overlapping symptoms, screening and treatment considerations, ...
PHIMT Fact Sheet
The Protected Health Information Management Tool (PHIMT), is the primary tool used by Military Health System (MHS) facilities for all release of information processing, management and compliance. The tool also serves many other critical features that are required by law including all major Health Insurance Portability and Accountability Act (HIPAA) ...
Talking to Your Child about TBI: A Guide for Caregivers of Service Members and Veterans
This TBICoE fact sheet includes age-appropriate strategies adults can use to speak with children about traumatic brain injury—or concussion. It also includes tips on how to help kids cope with changes that impact the family unit.
Addressing Family Needs: A Guide for Caregivers of Service Members and Veterans
This TBICoE fact sheet includes ways to build stronger family ties and develop coping strategies for challenges the family may experience after a loved one sustains a concussion—or TBI—such as substance misuse, psychological and emotional trauma, and financial changes.
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