Patient Resources

Forms

Fairchild AFB Forms

  • Interested in helping fund services at the 92d Medical Group (92 MDG)? If you have Other Health Insurance (OHI) other than TRICARE, Medicare, or Medicaid, you may be able to help!

    Our Third Party Collections (TPC) program attempts to capture OHI information on a DD Form 2569. Once you fill out a DD Form 2569 with your OHI information, our Uniform Business Office (UBO) will coordinate billing your insurance company for the services you receive from the 92 MDG at no cost to you!

DOD Forms

Defense Health Agency Forms

TRICARE Forms

Having problems downloading a Form?

If you’re getting an error message when downloading a form, then try:

  • Updating your Adobe Acrobat or Adobe Reader.
  • Downloading the file using Microsoft Edge. Chrome, Firefox, and other browsers no longer support opening PDFs.

If that doesn’t work, right-click on the form you’re trying to download and select “save-as” to save the form to your computer.

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