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

Forms

» DA Forms - https://armypubs.army.mil/ProductMaps/PubForm/DAForm.aspx

» Medical Evaluation Board Proceedings - DA Form 3947 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1002593

» PEBLO Estimated Disability Compensation Worksheet - DA Form 5892 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1001088

» Soldier's Medical Evaluation Board/Physical Evaluation Board Counseling Checklist - DA Form 5893 https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1006163

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