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Form/Template
10/25/2019
The Data Sharing Agreement Application (DSAA) is used when requesting data from systems that are owned and/or managed by DHA.
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Submit a Data Sharing Application
Form/Template
10/4/2019
Please attach MTF P&T Committee comments & meeting minutes, an explanation of the rationale for the request, copies of supporting clinical evidence, and anything else that needs to be considered by the DoD P&T Committee.
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TRICARE Formulary
Form/Template
9/30/2019
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the MHS GENESIS / Defense Healthcare Management System Modernization Electronic Health Record (DHMSM EHR)
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Electronic Health Record: MHS GENESIS
Form/Template
9/24/2019
This Air Force Medical Support Agency (AFMSA) Privacy Impact Assessment (PIA) summarizes the Dental Imaging Collaborative Environment (DICE) system.
Form/Template
9/24/2019
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the TRICARE E-Commerce (TMA ECS) system.
Form/Template
9/20/2019
This Military Health System (MHS) Privacy Impact Assessment (PIA) describes the Spectacle Request and Transmission System (SRTS). The SRTS is a Government developed clinic and laboratory web-based application that serves as the sole electronic system for ordering and tracking military eyewear.
Form/Template
8/29/2019
Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
Form/Template
8/29/2019
To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
Form/Template
8/29/2019
To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
Form/Template
8/29/2019
Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
Form/Template
8/29/2019
This process guides references how to submit Discharge Summary notification from Inpatient or Outpatient Medical Care at a VA Facility under DVA/DoD Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.
Form/Template
8/29/2019
This process guides references how to submit Request for Durable Medical Equipment for Pre- Authorization of Inpatient or Outpatient Medical Care at a VA Facility under DVA/DoD Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.
Form/Template
8/19/2019
This Privacy Impact Assessment (PIA) documents compliances for CIS-Essentris
Form/Template
8/12/2019
Some resources you can use to protect your vaccine storage unit and warn staff to not turn off power to the unit.
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Vaccine Storage and Handling
Form/Template
8/5/2019
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Theater Medical Information Program-Joint Composite Health Care System Caché (TC2).
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