Attention! If you live in the TRICARE West Region, or in a state or ZIP code moving to the West Region and you pay an enrollment fee or premium by recurring credit card, debit card, or electronic funds transfer, you must set up payment information with TriWest before Dec. 31, 2024. If you don’t take action, you’ll risk getting disenrolled. Learn more.

Patient Resources

Brooke Army Medical Center Forms

Patient Administration Forms

  • Medical Evaluation Board Proceedings
    Medical Evaluation Board Proceedings - DA FORM 3947

    Download Form
  • PEBLO Estimated Disability Compensation Worksheet
    PEBLO Estimated Disability Compensation Worksheet - DA Form 5892

    Download Form
  • Soldier's Medical Evaluation Board/Physical Evaluation Board Counseling Checklist
    Soldier's Medical Evaluation Board/Physical Evaluation Board Counseling Checklist - DA Form 5893

    Download Form

Third Party Collection Program Form

  • Third Party Collection Program/Medical Services Account/Other Health Insurance
    Third Party Collection Program/Medical Services Account/Other Health Insurance DD Form 2569

    Download Form

Defense Health Agency Forms

TRICARE Forms

Don’t forget to keep your family’s information up to date in DEERS!