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ADVISORY UPDATE AUG 21 - Hospital Operations Returning to Normal

IACH is pleased to announce that full operations will resume on Friday, Aug. 22. Following repairs to the hospital’s cooling systems, air conditioning is slowly being restored and services that were temporarily reduced are now fully available.

Patient Resources

Forms

Irwin Army Community Hospital-Riley Forms

Freedom of Information Act
FOIA Request Form
Patient Records
DD Form 2870 - Authorization for Disclosure of Medical or Dental Information

DA Form 5018-R - ADAPCP Client's Consent Statement for Release of Treatment Information

PAD Form

Radiology ROI (Non-Referral related)

DD Form 2870 - Appointment-Based Requests
Public Health
Fort Riley Water Inspection Form

Fort Riley Water Trailer Certification Guide

Pediatric and Adult Influenza Screening and Immunization Documentation
School & Sports Physicals
Child Medical Record Immunization History & Health Assessment Form

Child & Youth Services Sports Physicals Form

KSHSAA Sports Physical Form Rev 3/2024
Travel Documents
DTS Profile – Data Entry Form

DD 1351-3 - Statement of Actual Expenses

Confirmation of Specialty Care Form
Women's Health
OB Intake Paperwork
Third Party Collection Program/Medical Services Account/Other Health Insurance

Defense Health Agency Forms

TRICARE Forms

Download a TRICARE Form

Submit

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