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.
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
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
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 Patient Portal Fact Sheet
This fact sheet describes the MHS GENESIS Patient Portal.
MHS GENESIS Fact Sheet
This fact sheet describes the DOD’s electronic health record, MHS GENESIS.
Patient Encounter Processing and Reporting (PEPR)
PEPR allows analysis of purchased care claims data created by the TRICARE Managed Care Support Contractors.
Electronic Data Quality (EDQ)
Electronic Data Quality (EDQ) Fact Sheet
Military Health System (MHS) Population Health Portal (PHP)
Military Health System (MHS) Population Health Portal (PHP) Fact Sheet
Direct Access Reporting Tool (DART)
Direct Access Reporting Tool (DART) Fact Sheet
Health Information Exchange (HIE)
Health Information Exchange (HIE) Fact Sheet
Defense Occupational and Environmental Health Readiness System – Industrial Hygiene (DOEHRS-IH)
DOEHRS-IH allows the Department of Defense (DoD) to manage occupational and environmental health risk data and actively track biological, chemical, physical health hazards and engineered nano-object process to service members worldwide.
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