Forms
TRICARE West Region beneficiaries can find a variety of forms to print to assist with claims, enrollment and billing, or customer service fulfillment.
Claims
Enrollment and Billing
- Automatic Monthly TRICARE Payment Set Up Request
- Start, Change or Stop Your Allotment
- TRICARE Prime/Select/Reserve Recurring Credit Card/Electronic Funds Transfer payment (start or change request)
- TRICARE Young Adult Recurring Credit Card/Electronic Funds Transfer (start or change request)
- Enrollment Reconsideration Request
Enrollment Forms
- TRICARE Prime, Prime Remote, Prime Overseas, Prime Remote Overseas (DD 2876-2)
- TRICARE Select, Select Overseas (DD 3043-2)
- TRICARE Young Adult (DD 2947-2)
Customer Service
Last Updated 2/12/2025