Patient Resources

DHA Office of the Inspector General
Exceptional Family Member Program
FAQs
Forms
MHS Notice of Privacy Practices
Policies
Related Links

Forms

Defense Health Agency

DHA Form 116: Pediatric and Adult Influenza Screening and Immunization Documentation
DHA Form 207: COVID-19 Vaccine Screening and Immunization Document, v15

TRICARE Forms

Download a TRICARE Form

Don't forget to keep your family's information up-to-date in DEERS.

2803 Medical Campus Drive
Goldsboro, North Carolina 27531
USA

Stay Connected

Email Updates

Sign up to receive TRICARE updates and news releases via email.

www.tricare.mil is an official website of the Defense Health Agency (DHA), a component of the Military Health System.

The appearance of hyperlinks does not constitute endorsement by the DHA of non-U.S. Government sites or the information, products, or services contained therein. Although the DHA 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 hyperlinks are provided consistent with the stated purpose of this website.

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.

Need to Submit a Claim?

Send it to the correct claims address.

Need Technical Help?

Find the right contact info for the help you need.

DHA Address

7700 Arlington Boulevard
Suite 5101
Falls Church, VA 22042-5101

Privacy Policy
Privacy Program
Information Quality
Open Government
Plain Writing
Accessibility/Section 508
Fraud & Abuse
FOIA
No FEAR Act
USA.gov

Hosted by Defense Media Activity - WEB.mil