Military Medical Support Office MMSO Worksheet-01 Rev. 3/1/2013 MEDICAL ELIGIBILITY VERIFICATION Reserve Component Instructions: Member or unit representative completes Sections I and II. Unit representative.

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How to fill out the Mmso Form 1 online

Filling out the Mmso Form 1 online is an essential step for members seeking medical eligibility verification with the Military Medical Support Office. This guide provides a clear and comprehensive approach to complete the form accurately and efficiently.

Follow the steps to complete the Mmso Form 1 online.

  1. Select the ‘Get Form’ button to access the Mmso Form 1 and open it in your online document editor.
  2. Complete Section I, which requires patient data. Fill out the branch of service by checking the appropriate box and provide the individual's name, rank or grade, social security number, address, date of birth, and phone number.
  3. In Section II, provide treatment information. Record the date of injury or illness, the treatment occurrence dates, and describe the diagnosis or injury, including any available ICD9 codes.
  4. Proceed to Section III, the unit certification of eligibility. Select the type of orders applicable and fill in the name and distance of the nearest Military Treatment Facility. Then, provide details about the current unit of assignment, including the name, UIC/OPFAC, address, and phone number.
  5. Complete the certification section by providing the name, rank, and title of the point of contact, along with their phone number. Ensure that there is a signature and date from the certifying official.
  6. Once all sections are filled out and verified, attach any required documentation that corresponds to the treatment and confirm that all information matches. You are then ready to submit the form.
  7. After all corrections and confirmations, save your changes. You may choose to download, print, or share the completed Mmso Form 1 as needed.

Start filling out the Mmso Form 1 online to ensure timely processing of your medical eligibility verification.

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What is an Army Mmso?

The Military Medical Support Office (MMSO) supports remotely located active duty, Reservist, and National Guard service members in the Army, Navy, Marine Corps, Air Force and Coast Guard who must receive health care through civilian health care systems.

A: MMSO Form 1 covers eligibility and bill payment for a medical issue that is addressed and/or resolved in one visit. A: MMSO Form 2 is required for Soldiers who have a specific need for follow on care, or have a recommendation from the initial visit.

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