Forms
Accessing TRICARE DD 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 a form in your web-browser, 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 try accessing the form directly from the official DoD forms site.
Claims
Other Health Insurance (OHI) questionnaire
Public facility use certification form
Third party liability claim form (DD2527)
Billing and Enrollment
Billing and Payment Options
Set up recurring payment with bank account
Set up recurring payments with credit card
Log in to see your billing summary or make a payment
Enrollment Forms
Continued Health Care Benefit Program (CHCBP)
Prime enrollment, disenrollment and PCM change form (DD2876)
Select enrollment, disenrollment and change form (DD3043)
TRICARE Young Adult (TYA) application (DD2947)
HIPAA
General release of information authorization requests
General release of information authorizations should be completed online through beneficiary self-service. Sensitive diagnosis and revocation options are not available in self-service at this time.
Log in or register to submit a general release of information request.
Paper Submission Forms
Authorization for release of information form (general)
Authorization for release of information form (sensitive diagnosis)
Revocation of prior authorization
Miscellaneous
Red Hill
DHA’s Red Hill Public Health information page
Naval Health Clinic Hawaii Red Hill Clinic (for those on-island)
Email questions to dha.redhill@health.mil
Miscellaneous Forms
Case management referral form
COVID-19 Vaccine Screening and Immunization Documentation (DHA Form 207)
TRICARE Resources
TRICARE Health Matters newsletters
Last Updated 12/2/2024