Special Needs Program Management Information 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 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.
Looking for an official Defense Health Agency Form?
- 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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If that doesn’t work, right-click on the form you’re trying to download and select “save-as” to save the form to your computer.
Recent Forms & Templates
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Popular Forms & Templates
DHA-GL Worksheet 02: Pre-Authorization Request
Neurobehavioral Symptom Inventory Form
Patient Global Impression Change Scale
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CS SCE 2875
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Palmetto Government Benefits Administrator (PGBA)
We found 484 items
Fact Sheet
April 28, 2021
Help With Ongoing Symptoms Following Concussion/Mild TBI Fact Sheet
.PDF |
144.49 KB
Although the majority of service members recover from concussion with little to no intervention, some experience symptoms beyond the first three months after their initial injury. This fact sheet addresses why symptoms continue to persist in some patients and how they can cope or seek additional help.
Fact Sheet
Feb. 24, 2021
MAC Billing Quick Reference Guide
.PDF |
131.97 KB
MAC Billing Quick Reference Guide
Fact Sheet
Feb. 16, 2021
Key Themes in Digital Ethics
.PDF |
499.15 KB
This fact sheet provides an overview of key themes in ethics related to the use of digital health in clinical practice.
Fact Sheet
Feb. 16, 2021
Mobile Health Device Privacy and Security
.PDF |
365.27 KB
Tips and techniques for maintaining privacy and security of health information stored on mobile devices.
Fact Sheet
Jan. 29, 2021
Core Requirements for ASSET
.PDF |
497.66 KB
Requirements to attend EWSC ASSET+
Fact Sheet
Jan. 29, 2021
Core Requirements for COTS
.PDF |
470.58 KB
Course requirements to attend EWSC COTS+
Fact Sheet
Jan. 29, 2021
EWS Course V40 Objectives COTS
.PDF |
192.20 KB
EWSC COTS+ course objectives
Fact Sheet
Jan. 29, 2021
EWS Course V40 Objectives ASSET
.PDF |
188.60 KB
EWSC ASSET+ Course Objectives
Fact Sheet
Jan. 8, 2021
DMRTI_EWSC Student Criteria
.PDF |
80.83 KB
A reference for potential EWSC students.
Fact Sheet
Oct. 19, 2020
DHA UBO Frequently Asked Questions
.PDF |
169.87 KB
DHA Uniform Business Office (UBO) Helpdesk Frequently Asked Questions
Fact Sheet
Aug. 6, 2020
Heads Up; Sports Safety
.PDF |
222.12 KB
This fact sheet provides sports safety tips to prevent or minimize sports-related traumatic brain injury. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.
Fact Sheet
Aug. 6, 2020
Respect the Road
.PDF |
599.84 KB
One of the leading causes of military traumatic brain injury is motor vehicle crashes. This car safety fact sheet provides tips to help prevent TBI while driving a motor vehicle and safety measures to take to keep passengers safe. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.
Fact Sheet
Aug. 6, 2020
Ride Right Fact Sheet
.PDF |
454.20 KB
This bicycle safety fact sheet provides tips to protect your head and help prevent TBI while riding a bike. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.
Fact Sheet
Aug. 6, 2020
Head Check: Know Your Helmet, Bicycle and Motorcycle
.PDF |
493.00 KB
A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right ride, with information about different safety features in helmets for bicycling and riding motorcycles.
Fact Sheet
Aug. 6, 2020
Head Check: Know Your Helmet, Football and Baseball
.PDF |
204.05 KB
A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for football and baseball.
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