Live in the West Region? You still have time to set up your payment info if you pay by EFT, credit card, or debit card. If you have TRICARE Prime, TRICARE Select, TRICARE Young Adult, TRICARE Reserve Select, or TRICARE Retired Reserve, you now have until Feb. 28. If you miss this deadline, you will be disenrolled back to Jan. 1. Visit www.tricare.mil/west today.

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!