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Form/Template
Mar 25, 2024

Assisted Reproductive Services for the Benefit of Seriously or Severely Ill/Injured (Category II or III) Active Duty Service Members: Qualifying Service Member Information and Attestation

.PDF | 2.64 MB

The DHA Form 407 as an attestation from the Service member of their intent to parent any child born as a result of the covered Assisted Reproductive Technology (ART) services they are seeking. It also serves to collect information that will allow the Managed Care Support Contractor to link a referral to Service members and any TRICARE-enrolled ...

Form/Template
Mar 12, 2024

35th MDG Misawa MEDCOI

.PDF | 734.08 KB

Privacy impact assessment for the 35th Medical Group Misawa Air Base Medical Community of Interest.

Form/Template
Mar 12, 2024

Compliance Interagency Comprehensive Plan for Care Coordination Support

.PDF | 796.96 KB

Privacy impact assessment for the Interagency Comprehensive Plan for Care Coordination Support application supporting the Recovery Coordination Program's chief mission to improve the care, management, and transition of recovering service members.

Form/Template
Mar 12, 2024

Oak Harbor MedCOI

.PDF | 729.21 KB

Privacy impact assessment for the Oak Harbor MedCOI, Naval Health Clinic Oak Harbor Enclave.

Form/Template
Mar 12, 2024

Carl Zeiss Cirrus 5000 AI

.PDF | 733.10 KB

Privacy impact assessment for the Carl Zeiss Cirrus 5000 AI non-contact, high-resolution tomographic and bio-microscopic imaging device.

Form/Template
Mar 12, 2024

Womack AMC Ft Liberty MEDCOI

.PDF | 735.07 KB

Privacy impact assessment for the Womack AMC - Fort Liberty MEDCOI, an enclave architecture consisting of hardware, software, and telecommunications systems.

Form/Template
Mar 12, 2024

Dunham Army Health Clinic Enclave

.PDF | 736.12 KB

Privacy impact assessment for the Dunham Army Health Clinic Enclave Carlisle Barracks MEDCOI.

Form/Template
Mar 12, 2024

Optivision LMS ver 1 x

.PDF | 658.56 KB

Privacy impact assessment for the Optivision Laboratory Management System version 1.x, an ophthalmic management solution and interface (i.e., software) for eye glass grinding machines which make lenses for glasses.

Form/Template
Mar 12, 2024

377th MDG Kirtland AFB MEDCOI

.PDF | 739.98 KB

Privacy Impact Assessment for the 377th MDG Kirtland Air Force Base MEDCOI.

Form/Template
Mar 12, 2024

DML ES LogiCole

.PDF | 756.33 KB

Privacy impact assessment for the Defense Medical Logistics - Enterprise Solution - LogiCole which provides a fully integrated automated information system that supports medical logistics functionality including medical supply, equipment maintenance, facility management, and assemblage management.

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