DHA-GL Worksheet 08: DOD/VA MOA SCI-TBI-Blind DME Request Worksheet
To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
This website has recently undergone changes. As a result, the website is experiencing intermittent interruptions. We're aware of this issue and we're working to resolve these issues. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.
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.
If you’re getting an error message when downloading a form, then try:
If that doesn’t work, right-click on the form you’re trying to download and select “save-as” to save the form to your computer.
We found 533 items
To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
This process guides references how to submit Discharge Summary notification from Inpatient or Outpatient Medical Care at a VA Facility under DOD/VA Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.
Used to collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
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 DOD/VA Memorandum of Agreement (MOA) for Active Duty Service Members with SCI, TBI and/or Blind Diagnoses to Defense Health Agency Great Lakes DHA-GL.
To collect information from Military Health System beneficiaries in order to determine their eligibility for coverage under the TRICARE Program.
This Privacy Impact Assessment (PIA) documents compliances for CIS-Essentris
Some resources you can use to protect your vaccine storage unit and warn staff to not turn off power to the unit.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Theater Medical Information Program-Joint Composite Health Care System Caché (TC2).
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Air Force Medical Omnibus Web Applications (AFMOWAP)
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH) system.
Medical information received is considered during the consultative process and is used to form a database for education and research in pathology.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Medical Community of Interest (MedCOI) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Defense Medical Human Resources System - Internet (DMHRSi) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Enterprise Blade System Military Health Service Virtual (MHSV) system.
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.
You are leaving Health.mil View the external links disclaimer.