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Defense Health Agency Speaker Request Form

Form/Template

12/16/2016

Use this form to request a speaker from the Defense Health Agency. Try and submit your request as early as possible to allow our potential speakers time to coordinate their demanding schedules. 90 days of notice is a good rule of thumb, especially for events that require travel.

C4 Welcome Letter

Form/Template

11/2/2016

Welcome Letter for the DMRTI C4 Course

MTF NCPDP NPI Request Form

Form/Template

9/9/2016

Use this form to request a new NCPDP/NPI Number

MTF ePharmacy NCPDP NPI Request Form

Form/Template

9/9/2016

Use this form to requests a new ePharmacy NCPDP/NPI number

Vendor Information Form

Form/Template

7/27/2016

The Vendor Information Form provides a standard way to collect your ideas, problem statements, and/or proposed solution sets for defense health IT.

MTF ePharmacy Demographic Change Request Form

Form/Template

7/7/2016

For assistance completing this form or any other related information, e-mail the DHA PASS general mailbox dha.jbsa.pharmacy.mbx.pass@mail.mil or call the DHA PASS at 1-866-275-4732 / (210) 536-6650, press option 1.

TRICARE Webinar Feedback

Form/Template

6/27/2016

Use this form to submit feedback about the webinar on June 22, 2016 titled, "An Overview of the TRICARE Retail Refunds Program Dispute Resolution Process."

Family Reference Collection Form

Form/Template

6/22/2016

This form is used to establish a DNA reference specimen repository and database of information from kindred family members of unaccounted for/unidentified service members or other individuals needing to be identified. DNA will be extracted from a biological specimen or personal effect and used in identifying human remains.