Refrigerator Temperature Log - Fahrenheit

Temperature log for refrigerators storing vaccines, with form for recording vaccine storage troubleshooting.

Steps to take for Potentially Compromised Vaccine Event

Refrigerator Temperature Log - Celsius

Temperature log for refrigerators storing vaccines, with form for recording vaccine storage troubleshooting.

Freezer Temperature Log - Fahrenheit

Temperature log for freezers storing vaccines, with form for recording vaccine storage troubleshooting.

DHA Form 207: COVID-19 Vaccine Screening and Immunization Document, v19

The purpose of this form is to determine if the COVID-19 vaccine can be administered to the patient. (v19, April 2022)

Emergency Vaccine Retrieval and Storage Plan Worksheet

Sample WISDOM Agenda 5 Day

aCME Disclosure FY20 Fillable

Instructor CME Disclosure form

Research Repository Template

The RRT asks researchers whether they intend to put data into a repository, and if yes, what data and under what governance terms.

Data Sharing Agreement Application (DSAA)

The Data Sharing Agreement Application (DSAA) is used when requesting data from systems that are owned and/or managed by DHA.

EWSC Student Enrollment Form

Fillable student enrollment form for EWSC registration.

JOP Nomination Form

Student/nominee JOP course request form.

DHA Privacy Office Standard Contract Language

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.

HIPAA Safeguard Review of Non-Federal Systems (HSR)

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.

Dental Common Access System

Dental Common Access System (DENCAS)