Tip for DOD/VA-specific

You do not need a VA disability rating to register — service-connected injury or illness on or after 9/11 qualifies

Tip for DOD/VA-specific

WWP services are free to registered warriors and their families

Tip for DOD/VA-specific

Programs include combat stress recovery, long-term rehabilitative care, and caregiver support

Military / TRICAREhardDoctor signature required

Wounded Warrior Care Coordination Forms

DOD/VA-specific · DOD / VA

Coordination of care for severely injured service members transitioning between DOD and VA healthcare systems. Includes medical records transfer and benefits coordination.

Form Details

Total fields: 70
Auto-fillable: 35 (50%)
Time without BeneFill: 60 minutes
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Filled by: both
Frequency: per incident

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Where to Submit This Form

🌐

Contact the Wounded Warrior Project

1-888-997-2586. Available Monday-Friday, 9am-9pm ET.

🌐

https://www.woundedwarriorproject.org/programs/register

Complete the online registration to access programs and services.

🏢

Through your military medical treatment facility's Wounded Warrior or Recovery Care Coordinator

Service members can be enrolled through their Recovery Care Coordinator.

Required Attachments

📎 DD-214 or current military orders
📎 Documentation of service-connected injury or illness (VA rating letter, medical records, or Purple Heart orders)
📎 Completed registration form

Processing Time

Registration is typically processed within 1-2 weeks. A program specialist will contact you to discuss available services.

What Happens Next

A WWP representative will reach out to connect you with relevant programs: mental health, physical wellness, career counseling, benefits assistance, peer support, and family programs.

Tips for This Form

✓ You do not need a VA disability rating to register — service-connected injury or illness on or after 9/11 qualifies
✓ WWP services are free to registered warriors and their families
✓ Programs include combat stress recovery, long-term rehabilitative care, and caregiver support
✓ You can also be referred by a family member, VA social worker, or fellow veteran

More Military / TRICARE Forms

TRICARE DoD/CHAMPUS Medical Claim

DD Form 2642 · Department of Defense

TRICARE medical claim form for beneficiaries seeking reimbursement when providers do not file claims directly. Must attach itemized bill on provider letterhead. Used by active duty, retirees, and family members.

TRICARE Enrollment (milConnect/DEERS)

Online enrollment · Defense Health Agency

Enrollment in TRICARE plan options (Prime, Select, etc.) through milConnect or DEERS update. Requires valid military ID.

DEERS Enrollment Application

DD Form 1172-2 · Department of Defense

Application for Department of Defense Common Access Card (CAC) or DEERS Enrollment. Establishes beneficiary status for TRICARE eligibility.

TRICARE Referral / Pre-Authorization Request

Contractor-specific · TRICARE managed care contractors

Referral or prior authorization for specialty care, certain procedures, and medications under TRICARE Prime. Not required for TRICARE Select.

TRICARE Pharmacy Prior Authorization

Express Scripts PA form · Express Scripts (TRICARE pharmacy contractor)

Prior authorization for non-formulary medications or formulary drugs with utilization management requirements under TRICARE.

Post-Deployment Health Assessment

DD Form 2796 · Department of Defense

Post-Deployment Health Assessment completed by service members within 30 days of returning from deployment. Screens for deployment-related health concerns including mental health, environmental exposures, and injuries.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the DOD / VA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.