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!

TRICARE Forms

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