Form Information
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FORM NUMBER: DD2837

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TITLE: CONTINUED HEALTH CARE BENEFIT PROGRAM (CHCBP) APPLICATION

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EDITION DATE: 20100501 CANCELLATION DATE:

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AVAILABLE FILE FORMATS: PLEASE NOTE:
Fillable Adobe: If no hyperlink appears next to a format, the form is not available electronically.
Perform Pro: To obtain hard copies of current forms not available in electronic format, please
Form Flow 2.0: contact your own Military Service or DoD Component Forms Management
Form Flow 99: Officer. Cancelled forms are not available. Click on link for a list of Forms
Other: Management POCs.

Forms Management POCs

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REMARKS: Form only available at www.tricare.mil/chcbp
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ISSUANCES: 32 CFR 199.20
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SPONSOR / POC: HA SUB-SPONSOR: TMS OPS
NUMBER OF PAGES: 3
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USERS*: A N AF
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PRESCRIBED OR ADOPTED?: P

DISPOSITION: S

FUNCTION CODE: 6000

FORM CONTROLLED: N

MANDATORY PRINT SPECIFICATIONS: N

RCS:

IRCN:

OMB: 0704-0364

PRIVACY ACT IMPLICATIONS: Y
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* All revisions and/or cancellations must be coordinated through these USERS.

DISPOSITION: S = Do NOT use previous edition. U = Use previous edition until supply is depleted.