UCCI – Statement of Work (SOW) Dental Coverage for all Active Duty Service Members (ADSMs)
FOIA Library
Learn more about the Freedom of Information Act (FOIA) Reading Room, which is part of the 1996 amendments to FOIA, mandating publicly accessible "electronic reading rooms" with agency FOIA response materials and other information routinely available to the public.
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.
Recent FOIA Documents
Delta Dental – TRICARE Retiree Dental Program (TRDP) coverage Statement of Work (SOW)
Identification and Validation of Other Health Insurance
Direct Care encounters for Multiple Sclerosis
TRICARE beneficiaries with a diagnosis of Parkinson's Disease
Number of office visits for PCOS as well as the number of diagnoses for fatigue in a 1 year timeframe
Direct Care encounters for Chronic Bronchitis, Emphysema, Bronchiectasis, and Chronic Airway Obstruction
2009 Autism Spectrum Disorder - FOIA Terms and Conditions 2
Government Required MTF Prime Service Areas
Service Assist Team After Action Report - DD Form 1423-1 Contract Data Requierments List
Popular FOIA Documents
We found 621 items
Form/Template
Oct. 7, 2022
DHA Form 249: Pharmacy Data Warehouse Data Report Request Form
.PDF |
36.10 KB
DHA Form 249: Pharmacy Data Warehouse Data Report Request Form. To download the form , right-click and select "Save Link As". To open the form, right-click and select "Open with Adobe Acrobat."
Form/Template
Oct. 4, 2022
Web MEDCASE Requirements and Execution 1.x A&A 2990
.PDF |
755.20 KB
Web MEDCASE Requirements and Execution 1.x A&A 2990 privacy impact assessment
Form/Template
July 21, 2022
Enterprise Patient Queuing and Notification System (ePQNS)
.PDF |
678.33 KB
The Enterprise Patient Queuing Notification System (ePQNS) automates patient check-in during visits to Military Treatment Facilities (MTFs) and clinics. ePQNS provides real-time information to leadership to manage assets as wait-times increase or the situation dictates. It also allows MTFs to determine inefficiencies, identify best practices, and ...
Form/Template
March 21, 2022
Assistance Reporting Tool (ART)
.PDF |
704.13 KB
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Assistance Reporting Tool (ART) system.
Form/Template
March 10, 2022
Armed Forces Billing and Collection Utilization Solution - Amazon Web Services
.PDF |
771.75 KB
The Armed Forces Billing and Collection Utilization Solution (ABACUS) provides a standard patient accounting system for health care billing practices.
Form/Template
Feb. 8, 2022
3D Bio CAD 3 Shape TRIOS 3
.PDF |
657.91 KB
3D Bio CAD 3 Shape TRIOS 3 (“TRIOS 3”) Wireless Scanner captures digital images of the teeth used to design and fabricate dental appliances.
Form/Template
Oct. 20, 2021
National Optronics 7Ex Optical Fabrication Edger
.PDF |
645.42 KB
7Ex is a single purpose programmable instrument that edges high base lenses using the 7Ex's unique cutter design. Performs drilling and grooving in one process with the flexibility to process all bevel cutting types.
Form/Template
Aug. 1, 2021
DD Form 3042
This form is used to periodically assess the health and well-being of active duty and reserve military servicemembers regarding force health readiness and servicemembers' suitability for deployment.
Form/Template
June 29, 2021
TBI Caregiver Support Forms
.PDF |
466.86 KB
This is a fillable and printer-friendly version of the forms available in the "Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans."
Form/Template
Jan. 29, 2021
aCME Disclosure FY20 Fillable
.PDF |
122.87 KB
Instructor CME Disclosure form
Form/Template
Jan. 20, 2021
Research Repository Template
.PDF |
287.66 KB
The RRT asks researchers whether they intend to put data into a repository, and if yes, what data and under what governance terms.
Form/Template
Oct. 27, 2020
DHA Privacy Office Standard Contract Language
.PDF |
267.81 KB
This Section addresses the Contractor’s requirements under The Privacy Act of 1974 (Privacy Act), The Freedom of Information Act (FOIA), and The Health Insurance Privacy and Accountability Act (HIPAA) as set forth in applicable statutes, implementing regulations and DOD issuances.
Form/Template
Oct. 1, 2020
HIPAA Safeguard Review of Non-Federal Systems (HSR)
.PDF |
819.78 KB
The HIPAA Safeguard Review of Non-Federal Systems (HSR) is used when data obtained through a DSAA will be stored, transmitted, processed, or otherwise maintained on a non-federal information system.
Form/Template
April 1, 2020
MDR Special Justification Form
.PDF |
99.98 KB
Military Health System Data Repository (MDR) Special Justification Form. MDR Users will use this to request access to special tables in the MDR.
Form/Template
March 1, 2020
Routine Immunization Screening Form Adult
Routine immunization screening form for Adults
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