Armed Forces Health Surveillance Division (AFHSD) Epidemiology and Analysis AFHSD 501 Request Form

Privacy Impact Assessment, 81st Medical Group (MDG) Keesler Air Force Base (AFB) Medical Community of Interest (MEDCOI).

Privacy Impact Assessment, Clinical Information System .mil Enclave

Privacy Impact Assessment

Philips DigiTrak XT Recorder - Holter System v3.X A&I privacy impact assessment

Draeger Infinity Delta Series A&I privacy impact assessment

Privacy Impact Assessment, Automated Information Discovery Environment Medical Common Operating Picture (AIDE MedCOP).

Use this form to transfer Products or NDCs between Manufacturer Labelers, for billing purposes, in the TRICARE Retail Refund Program.

This template shall be used to modify an executed Data Sharing Agreement (DSA) that incorporates an approved Data Sharing Agreement Application (DSAA).

This template shall be used to request a 30 day extension in order to continue to use the data in accordance to the executed Data Sharing Agreement (DSA).

This checklist is designed to ensure you have completed the Data Sharing Agreement Application (DSAA) pre-submission reviews and have the necessary documentation to submit a DSAA. You must complete and submit this Prerequisite Checklist (PRC) to the Defense Health Agency (DHA) Privacy and Civil Liberties Office (PCLO) before you submit a DSAA or it ...

This template is used to assist the Defense Health Agency (DHA) Privacy and Civil Liberties Office (Privacy Office) with its consideration of prospective data uses involving DHA data.

This template shall be used to renew an executed Data Sharing Agreement (DSA) that incorporates an approved Data Sharing Agreement Application (DSAA). Submit this completed request or questions to the DHA Privacy and Civil Liberties Office (Privacy Office) at dha.ncr.j-6.mbx.dsa-mail@health.mil.

Privacy Impact Assessment

TRICARE Dispute Resolution Form for manufacturers. For use on resubmitted rejected disputes.