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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- Please visit the DHA Forms Management page on Inside DHA. CAC authentication is required.
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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
Oral Communication of PHI
This HIPAA Information Paper describes Oral Communication of PHI (updated July 2015)
Shields Save Sight On Duty and Off
This fact sheet is intended to remind individual's to do everything they can to shield their eyes against accidents while on and off duty with protective eye wear
Shields Save Sight Fit the Gear to the Job
This fact sheet is intended to remind individual's to wear the appropriate safety and protective eyewear for the job or task at hand. Wearing eyewear from the Authorized Protective Eyewear List will help provide the best level of protection.
Shields Save Sight 3 Steps to Save Sight
This factsheet outlines 3 important steps to take when there is an eye injury and how properly responding can save the person's sight.
Uses and Disclosures When an Authorization is Not Required
This HIPAA Information Paper describes the Uses and Disclosures When an Authorization is Not Required.
Victims of Abuse, Neglect, or Domestic Violence
This HIPAA Information Paper describes the Victims of Abuse, Neglect, or Domestic Violence (updated June 2015).
Judicial and Administrative Proceedings
This HIPAA Information Paper describes Judicial and Administrative Proceedings (updated July 2011).
Person or Entity Authentication For Information System Access
This HIPAA Information Paper describes Person or Entity Authentication For Information System Access (Updated March 2015).
Camera and Video Use in a Covered Entity
This HIPAA Information Paper describes Camera and Video Use in a Covered Entity.
Specifications: Standards and Implementation
This HIPAA Information Paper describes Specifications: Standards and Implementation.
Overview of the HIPAA Security Rule
This HIPAA Information Paper describes the Overview of the HIPAA Security Rule.
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.
Cognitive Rehabilitation Therapy Fact Sheet
Explains the TRICARE Cognitive Rehabilitation Therapy benefit
Think You're Too Young for Medicare?
Explains Medicare requirements for injured service members on disability
Coverage of Assisted Reproductive Services
Fact sheet that describes coverage for assisted reproductive services for injured serivce members.
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