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
Prior authorization bypass drugs and criteria
This reference provides special prior authorization rules and background for specific drug groups.
Patient Registry Factsheet
The Anomalous Health Incidents Patient Registry collects patient information after an AHI event.
Anomalous Health Incident Factsheet
AHI is the term used to describe a series of unexplained and sudden symptoms associated with the acute onset of a sensory event, such as pressure, heat, loud sounds, or other auditory phenomena.
Medical Pathways Factsheet
Durable Medical Equipment is a term for reusable devices or equipment prescribed by a provider for a patient’s use to support a related medical condition
Joint Patient Safety Reporting (JPSR)
JPSR integrates patient safety data from the DHA and the Department of Veterans Affairs’ National Center for Patient Safety into a single system for quantitative and comparative data analysis.
Identity Authentication Services
IAS is an authentication and authorization suite that supplies a robust mechanism for secure Public Key Infrastructure services within the Military Health System. IAS protects access to authorized systems and beneficiary information.
Expense Assignment System
EAS is a Web-based tool essential to the Department of Defense because it assists the Defense Health Agency in identifying the total cost of providing health care to TRICARE patients.
MP2BET
The MHS Planning, Programming, Budget, and Execution Tool facilitates data-driven metrics, assessments, and analysis throughout the Planning, Programming, and Budgeting Execution processes for the Defense Health Program funding requirements.
Purchased Care Operating System
The Purchased Care Operating System is composed of TRICARE Encounter Data and Patient Encounter Process Reporting. The TED system processes TRICARE healthcare claims and the PEPR system reports and analyzes the claims processed by TED.
Nutrition Management Information System
NMIS is a fully integrated nutrition management system supporting military readiness and the war fighter worldwide.
Paper Record Tracking
PRT is an application that manages and tracks physical medical records that are stored in record rooms at military hospitals and clinics.
Special Needs Program Management Information System
SNPMIS documents and reports on services provided to TRICARE patients with special needs.
DHA Referral Management Fax Solution
The Defense Health Agency RMFS is a cybersecurity compliant electronic fax tool that streamlines paperless faxing. Hosted on the DHA network, this solution enhances security compliance, reduces manual printing and faxing, and allows uploading and downloading of transmissions directly into MHS GENESIS, and the Health Artifact and Image Management System.
Service Treatment Record Processing Operations Reporting Tracking Solution
Service Treatment Record Processing Operations Reporting Tracking Solution is a web-based solution that uses a commercial enterprise content management system to assemble, track, and monitor the creation of uniformed service members’ Service Treatment Records. It automates the collection of health record information, streamlining processes and ...
Capacity Services
Capacity Services is a hosting facility provided by the Defense Information Systems Agency and offers Infrastructure-as-a-Service to applications within the Solution Delivery Division.
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