Alert: The date on Third Party Liability form DD2527 shows that it has expired. Please continue to use this form. We will accept it until the DoD releases a new, updated version. You can find the form here.

Forms

Accessing TRICARE Department of Defense Forms:

Due to security settings, you may not be able to view certain DD forms in your web browser. If you encounter an issue viewing these forms, right-click and select "Save as" to save to your computer. You can then open the form using your system's default program for viewing PDFs. You can also access forms directly on the official DOD forms site.

Claims

Appointment Of Representative

Claim Form (DD2642)

OHI Questionnaire

Public Facility Use Certification Form

Timely Filing Waiver

Third-Party Liability Claim Form (DD2527)

Billing and Enrollment

Billing and Payment Options

Make a Payment

Set up Allotment

Set up Recurring Payment With Bank Account

Set up Recurring Payments With Credit Card

Enrollment Forms

CHCBP

Prime Enrollment, Disenrollment, and PCM Change Form (DD2876)

Select Enrollment, Disenrollment, and Change Form (DD3043)

TYA Application (DD2947)

HIPAA

General Release of Information Authorization Requests

Complete general release of information authorizations online through beneficiary self-service. Sensitive diagnosis and revocation options are not available in self-service. Log in or register to submit a request.