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

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.