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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 five 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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We found 477 items

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Form/Template
Aug 23, 2022

Military Health System Information Platform PIA

.PDF | 688.46 KB

The Military Health Systems (MHS) Information Platform (MIP) is a system containing multiple dashboards and databases that deliver enterprise clinical data capabilities. The capabilities provided by MIP are: Program Management; Data Warehousing; Application Portal; Infrastructure and Operations; Application Support; Business Intelligence; Analytics; ...

Form/Template
Aug 12, 2022

Composite Health Care System (CHCS)

.PDF | 2.35 MB

Composite Health care System (CHCS) is a fully integrated health care information system used in Department of Defense (DOD) Military Treatment Facilities (MTFs) and clinics. It is used to automate and integrate the functions performed by the hospital staff and to facilitate the delivery of health care and MTF's administration. Data elements include ...

Form/Template
Aug 12, 2022

Naval Hospital Jacksonville (NHJAX) Enclave

.PDF | 654.57 KB

Complete this form for DOD information systems or electronic collections of information that collect, maintain, use, and/or disseminate PII about members of the public, Federal employees, contractors, or foreign nationals employed at U.S. military facilities internationally.

Form/Template
Jul 21, 2022

Enterprise Patient Queuing and Notification System (ePQNS)

.PDF | 678.33 KB

The Enterprise Patient Queuing Notification System (ePQNS) automates patient check-in during visits to Military Treatment Facilities (MTFs) and clinics. ePQNS provides real-time information to leadership to manage assets as wait-times increase or the situation dictates. It also allows MTFs to determine inefficiencies, identify best practices, and ...

Form/Template
Jul 12, 2022

Enterprise Blood Management System (EBMS) - Transfusion

.PDF | 664.09 KB

The purpose of Enterprise Blood Management System (EBMS)-Transfusion, formerly known as Blood Management Blood Bank Transfusion Service (BMBB/TS), is managing the blood transfusion aspect of the Armed Services Blood Program (ASBP), including blood records, blood orders, and transfusion patient information in the Continental United States and Outside ...

Form/Template
May 3, 2022

TRICARE Online (TOL) System

.PDF | 668.74 KB

TRICARE Online (TOL) is a Department of Defense (DOD) Online Patient Portal (PP) which provides eligible beneficiaries with the following: access to Military Treatment Facilities' (MTFs) appointments, new prescription (Rx) fill and refills, health record data, service separation/retirement information as well as access to secure messaging (SM), and ...

Form/Template
Mar 21, 2022

Assistance Reporting Tool (ART)

.PDF | 704.13 KB

This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Assistance Reporting Tool (ART) system.

Form/Template
Mar 10, 2022

Consolidated Information Center Data Warehouse

.PDF | 804.63 KB

The Consolidated Information Center (CIC) Data Warehouse is used to facilitate the Bureau of Medicine and Surgery's analytical capabilities across Navy Medicine to improve speed of decision making.

Form/Template
Feb 28, 2022

HIV Management Service (HMS)

.PDF | 746.00 KB

HIV Management Service (HMS) is a Private web-based information management system, owned, operated and maintained by the Navy Bloodborne Infection Management Center, used to conduct infectious disease-related administrative reporting, patient tracking, and allows Infectious Disease on-line transaction processing (OLTP) to access, validate, and conduct ...

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