Live in the West Region? There is now a referral approval waiver in place through June 30, 2025. Learn More About the Referral Approval Waiver.

Patient Resources

Forms

Fairchild AFB Forms

  • DD Form 2569
    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!

Defense Health Agency Forms

TRICARE Forms

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