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
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
Amputation Care Equipment Requirements
This fact sheet describes equipment needs for amputees based on level and number of amputations.
VHA TRAIN
VHA TRAIN is an external learning management system to provide valuable, Veteran-focused, accredited, continuing medical education at no cost to community health care providers.
DHA-PGI 224: Protection of Privacy and Freedom of Information
Personally Identifiable Information (PII), Protected Health Information (PHI), and Federal Information Requirements
The Defense Medical Epidemiology Database System Overview Fact Sheet
This fact sheet provides a system overview of the Defense Medical Epidemiology Database (DMED). DMED is a web-based tool to remotely query de-identified active component personnel and medical event data contained within the Defense Medical Surveillance System (DMSS). Learn about the newly released version of DMED and its key features in this document.
Osseointegration
This fact sheet provides information on osseointegration (OI) and the use of this procedure for the direct skeletal attachment of prosthetic limbs in Military Health System (MHS) beneficiaries with amputations.
HIPAA Electronic Funds Transfer and Remittance Advice Fact Sheet
TRICARE Managed Care Support Contractors (MCSCs), acting as a health plan/payer, are required to accommodate and be compliant with the transactions for Health Care Electronic Funds Transfers (EFTs) and Remittance Advice (RA). These standards intended to streamline the format and data content of transmissions a health plan sends to its bank when it ...
HIPAA Operating Rules
The Department of Health and Human Services (HHS) establishes a single set of operating rules for each Health Insurance Portability and Accountability Act (HIPAA) transaction and promulgate rules to establish its adoption. Operating Rules affect TRICARE where it employs HIPAA electronic transactions in Private Sector Care as a Health Plan/Payer and in ...
Demographic and Military Traits of Service Members Diagnosed as Traumatic Brain Injury Cases
This fact sheet provides details on the demographic and military traits of service members diagnosed as traumatic brain injury (TBI) cases during a 16-year surveillance period from 2001 through 2016, a total of 276,858 active component service members received first-time diagnoses of TBI - a structural alteration of the brain or physiological ...
Rhabdomyolysis by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet
This fact sheet provides details on Rhabdomyolysis by location for active component, U.S. Armed Forces during a five-year surveillance period from 2012 through 2016. The medical treatment facilities at nine installations diagnosed at least 50 cases each and, together approximately half (49.9%) of all diagnosed cases.
Heat Illnesses by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet
This fact sheet provides details on heat illnesses by location during a five-year surveillance period from 2012 through 2016. 11,967 heat-related illnesses were diagnosed at more than 250 military installations and geographic locations worldwide. Three Army Installations accounted for close to one-third of all heat illnesses during the period.
Assessment and Management of Oculomotor Dysfunctions Associated with Traumatic Brain Injury Fact Sheet
This fact sheet is intended to assist all who provide rehabilitative care to survivors of traumatic brain injury (TBI) affected by visual dysfunctions. The information contains accepted practices for rehabilitation and treatment strategies for oculomotor dysfunctions.
RFQ HT9402-16-Q-0017
Formulary Management RFQ from the November 2016 P&T Committee Meeting
Decision Tree Matrix for Contracts with PII/PHI
Personally Identifiable Information (PII), Protected Health Information (PHI), and Federal Information Requirements
Pre-Proposal Meeting Minutes
Meeting Minutes from August 23, 2016 Pre-Proposal Teleconference.
Visual Field Loss Fact Sheet
This fact sheet is an overview of accepted practices for rehabilitation strategies for visual field loss and is intended to assist all who provide eye care and rehabilitation to individuals with visual field loss caused by traumatic or acquired brain injury.
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