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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 two 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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Article 4 Table

Report
8/1/2023

Article 4 Table - Reportable Medical Events, Military Health System Facilities, Week Ending July 1, 2023.

Article 2 Table 1

Report
8/1/2023

Article 2 Table 2

Report
8/1/2023

Article 2 Table 2 - Antibiotic Resistance Genes Carried by the Sequence Type 410 Escherichia coli Isolated from the Initial Urinary Culture, Tripler Army Medical Center.

Article 1 Table 2

Report
8/1/2023

MSMR Vol. 30 No. 8 - August 2023

Report
8/1/2023

The August 2023 MSMR provides the most recent data from the active surveillance program for acute respiratory disease and Group A Beta-Hemolytic Streptococcus among U.S. Army basic trainees; then summarizes the case report of an extensively resistant E. coli in a returning traveler at Hawai'i's Tripler Army Medical Center; followed by a Surveillance Snapshot of Pseudofolliculitis barbae cases among active component service members from 2000 to 2022; and concludes with the latest monthly reportable medical event summary for the active component and Military Health System beneficiaries.

Digital Pathology Program

Fact Sheet
7/31/2023

The Digital Pathology Program is a partnership between the Solution Delivery Division and the Joint Pathology Center to digitize their pathology medical data.

MedCOP Fact Sheet

Fact Sheet
7/31/2023

Medical Common Operating Picture is the joint system of record and an interactive platform that enables medical command and control/medical situational awareness decision making, by leveraging enhanced digital tools to analyze and visualize data from the tactical to strategic levels. MedCOP facilitates real-time operational medicine information sharing and data synchronization across multiple network domains to provide a globally accessible, relevant, resilient, and integrated medical common operating picture.

Defense Health Agency Strategic Plan

Publication
7/31/2023

The Defense Health Agency Strategic Plan for fiscal years 2023-2028.

Advance Directives

DHA Publication

Establishes DHA's procedures on providing patient educational materials and administrative filing of the advance directive medical legal correspondence into the DOD Health Record at military medical treatment facilities.

  • Identification #: 6025.02
  • Date: 7/27/2023
  • Type: DHA-AI
  • Topics: N/A

Military Medical Treatment Facility Pharmacy Formulary Policy

DHA Publication

Establishes DHA's procedures to implement standardized and efficient Military Medical Treatment Facility Pharmacy Operations.

  • Identification #: 6025.17
  • Date: 7/27/2023
  • Type: DHA-AI
  • Topics: N/A

Example of a Positive Toxicology Final Report

Technical Document
7/27/2023

Pages 4-16 to 4-19: Potentially Compromised Temperature Sensitive Medical Product Worksheet

Publication
7/27/2023

Errata sheet for Immunization Toolkit Ninth Edition. Pages 4-16 to 4-19: PC and TSMP Worksheets.

Page 4-15: Steps to take for Potentially Compromised Vaccine Event

Publication
7/27/2023

Errata sheet for Immunization Toolkit Ninth Edition

Pages 4-6 and 4-7: Sample Vaccine Temperature Logs

Publication
7/27/2023

Errata sheets for Immunization Toolkit Ninth Edition

Medical Quality Assurance and Clinical Quality Management in the Military Health System

Policy

This Instruction reissues DOD Directive 6025.13 (Reference (a)) as a DOD Instruction in accordance with the authority in DoDD 5124.02 (Reference (b)), and establishes DOD policy on issues related to MQA programs and clinical quality management activities.

  • Identification #: DoD Instruction Number 6025.13
  • Date: 7/26/2023
  • Type: Instructions
  • Topics: N/A
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Last Updated: July 11, 2023
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