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HIPAA Release Form

In accordance with the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996, we cannot provide to a Member of Congress a beneficiary’s private medical information without a signed Authorization for Disclosure of Medical or Dental Information form—commonly known as the HIPAA release form.

Please include a signed copy of the HIPAA release form and submit with any questions regarding TRICARE.

“On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."
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The appearance of hyperlinks to external Web sites does not constitute endorsement by the TRICARE Management Activity of these Web sites or the information, products or services contained therein. For other than authorized government activities, TRICARE Management Activity does not exercise any editorial control over the information you may find at other locations. Such links are provided consistent with the stated purpose of this DoD Web site. Accessibility/Section 508