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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Recent Forms & Templates
35th MDG Misawa AB MEDCOI
Online Base of Information Widely Accessible over Network
MHS GENESIS OC3 Electronic Health Record CORE
Navy Medicine Enterprise Web Services
Keller ACH - West Point MEDCOI
Nutrition Management Information System
Automated Neuropsychological Assessment Metrics Military Performance Database
Anatomic Pathology Laboratory Information System
375th MDG Scott AFB MEDCOI
Popular Forms & Templates
DHA-GL Worksheet 02: Pre-Authorization Request
Neurobehavioral Symptom Inventory Form
Patient Global Impression Change Scale
DHA-GL Worksheet 01: Medical Eligibility Verification
Medical Readiness Decision Support System (MRDSS)
Limited Duty Sailor and Marine Readiness Tracker MHS Application Access Gateways
Financial Management Information System
CS SCE 2875
DHA-GL Worksheet 03: Formal Appeal Request
Palmetto Government Benefits Administrator (PGBA)
We found 484 items
Cruise with Control
One of the leading causes of military traumatic brain injury is motor vehicle crashes. This fact sheet provides tips on how to stay safe on motorcycles to help prevent TBI while riding. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.
Head Check: Know Your Helmet, Winter Sports
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 skiing, snowboarding and snowmobiling.
Fact Sheet: Joint Health Information Exchange
Joint Health Information Exchange (jHIE) is a secure network that shares your health information.
Frequently Asked Questions: Joint Health Information Exchange
Questions and answers about the MHS Joint HIE
Neck Pain Following Concussion/mTBI Fact Sheet
Neck pain can occur together with headaches following a concussion. This TBICoE fact sheet provides information to help patients manage neck pain. Various techniques are explained, including the use of heat or cold therapy, neck stretches, proper sleep positions and common activities that may contribute to neck strain.
Ways to Improve Your Memory Following Concussion/mTBI Fact Sheet
This TBICoE fact sheet can be used by health care providers to educate patients with concussion, or mild traumatic brain injury, on how to manage memory problems related to their injury.
Concussion/Mild TBI Signs and Symptoms Spanish Version Fact Sheet
This fact sheet — in Spanish — identifies major physical, cognitive and emotional symptoms of concussion/mild TBI, and provides coping and recovery tips.
Concussion/Mild TBI Signs and Symptoms Fact Sheet
This TBICoE fact sheet identifies major physical, cognitive, and emotional symptoms of concussion, or mild TBI, and provides coping and recovery tips.
Defense Health Agency Great Lakes Process Guide
This guide was developed to assist active duty, reservist, guard members, unit medical and command representatives with commonly used DHA-GL services (or processes).
How to submit Initial pre-authorization DVA/DOD MOA
This process guides references how to submit an INITIAL Request for Pre-Authorization of Inpatient or Outpatient Medical Care at a VA Facility under DVA/DOD Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency-Great Lakes.
How to submit Continuity of Care pre-authorization DVA/DOD MOA
This process guides references how to submit Request for Continuity of Care for Pre-Authorization of Inpatient or Outpatient Medical Care at a VA Facility under DVA/DOD Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency-Great Lakes.
Anti-Coagulation Therapy Monitoring (COAG CLINIC)
SDD Anti-Coagulation Therapy Monitoring (COAG CLINIC) Fact Sheet
Theater Medical Data Store Fact Sheet
Theater Medical Data Store (TMDS) is a Non-Classified Internet Protocol Router Network (NIPRNet)-based web system that allows providers to view and document a patient’s complete operational electronic health record by compiling his/her health history from various electronic military health care systems within the operational environment.
MHS GENESIS Cybersecurity Fact Sheet
This fact sheet describes the MHS GENESIS Cybersecurity transformation.
MHS GENESIS Fact Sheet
This fact sheet describes the DOD’s electronic health record, MHS GENESIS.
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