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
Fact Sheet
Feb. 4, 2015
Camera and Video Use in a Covered Entity
.PDF |
414.37 KB
This HIPAA Information Paper describes Camera and Video Use in a Covered Entity.
Fact Sheet
Jan. 22, 2015
Specifications: Standards and Implementation
.PDF |
461.23 KB
This HIPAA Information Paper describes Specifications: Standards and Implementation.
Fact Sheet
Dec. 17, 2014
Overview of the HIPAA Security Rule
.PDF |
173.35 KB
This HIPAA Information Paper describes the Overview of the HIPAA Security Rule.
Fact Sheet
Dec. 1, 2014
Depleted Uranium Information for Veterans and Their Families
A resource for veterans and their families from the VA Public Health Center. Discusses the VA DU Follow-Up Program.
Fact Sheet
Oct. 28, 2014
Cognitive Rehabilitation Therapy Fact Sheet
.PDF |
327.07 KB
Explains the TRICARE Cognitive Rehabilitation Therapy benefit
Fact Sheet
Oct. 28, 2014
Think You're Too Young for Medicare?
.PDF |
913.80 KB
Explains Medicare requirements for injured service members on disability
Fact Sheet
Oct. 28, 2014
Coverage of Assisted Reproductive Services
.PDF |
499.55 KB
Fact sheet that describes coverage for assisted reproductive services for injured serivce members.
Fact Sheet
Oct. 28, 2014
Information for Combat Veterans
.PDF |
269.96 KB
Fact sheet that discusses benefits for wounded, ill or injured service members.
Fact Sheet
Oct. 28, 2014
CAP Wounded Service Member Initiative
.PDF |
1.12 MB
CAP Supports Wounded Service Member Initiative provides needs assessments, assistive technology, and training to our nation’s wounded service members throughout all phases of recovery and the transition to employment.
Fact Sheet
Oct. 1, 2014
Disclosures in Emergency Situations (Updated November 2024)
.PDF |
273.14 KB
This HIPAA Information Paper describes the Disclosures in Emergency Situations (updated November 2024).
Fact Sheet
Oct. 1, 2014
Sending and Receiving PHI by Facsimile
.PDF |
459.59 KB
This HIPAA Information Paper describes the Sending and Receiving PHI by Facsimile (updated August 2010).
Fact Sheet
Oct. 1, 2014
Encryption of E-Mail
.PDF |
195.71 KB
This HIPAA Information Paper describes Encryption of E-Mail (updated September 2012).
Fact Sheet
Oct. 1, 2014
Assigned Responsibility
.PDF |
195.52 KB
This HIPAA Information Paper describes Assigned Responsibility (uppdated March 2010).
Fact Sheet
Oct. 1, 2014
The Privacy Rule and Documentation
.PDF |
131.23 KB
This HIPAA Information Paper describes the Privacy Rule and Documentation.
Fact Sheet
Oct. 1, 2014
Organized Health Care Arrangements
.PDF |
251.51 KB
This HIPAA Information Paper describes Organized Health Care Arrangements (update July 2011).
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