Live in the West Region? There is now a referral approval waiver in place through March 31, 2025. Learn More
Also, you have until March 31 to set up your payment info if you pay by EFT, credit card, or debit card. This is for TRICARE Prime, TRICARE Select, TYA, TRS, and TRR plans. If you miss this deadline, you will be disenrolled back to Jan. 1. Visit www.tricare.mil/west today.

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!