Data Sharing Agreement Application (DSAA)
Submit a DSAA when requesting data from systems that are owned and/or managed by TRICARE Management Activity (TMA). The DSAA replaces all previous versions of both the Data Use
Agreement (DUA) request template for personally identifiable information (PII), protected health information (PHI), and/or limited data set (LDS) data as well as the De-identified Files (DIF) DSA template.
Data Request Templates
Attach a Data Request Template (DRT) for each system indicated in Section 6 of the DSAA. Choose from the DRTs listed below. The DSAA request will be considered incomplete without the required attachment(s).
DRT_Military Health System Data Repository (MDR) Extractions
General DRT Extractions (for all other TMA Systems)
Access by Login:
DRT_Access by Login (all TMA Systems)
System Security Verification (SSV)
Submit when data obtained through a DSAA will be stored, transmitted, processed, or otherwise maintained on an information system that has not been granted a Department of Defense (DoD)
Authorization to Operate (ATO) or an Interim Authorization to Operate (IATO).
DSA – Change of Government Sponsor
Submit within 15 days of a Government Sponsor transition to the list the new Sponsor in the executed DSA.
DSA – Change of Applicant/Recipient
Submit within 15 days of an Applicant/Recipient transition to the list the new Applicant/Recipient in the executed DSA.
DSA – Modification Request
Submit to request modification of an executed DSA.
DSA – Extension Request
Submit to request a 30 day extension of an executed DSA.
DSA – Renewal Request
Submit to request the renewal of an executed DSA.
DSA – Certification of Data Disposition (CDD)
Submit to the Privacy Office within 30 days of expiration of the DSA (unless a request to renew the DSA will be submitted) or the end of the project, whichever comes first, to
certify that the data used in connection with the executed DSA was appropriately disposed.
“On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."
7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101
The appearance of hyperlinks to external Web sites does not constitute
endorsement by the Defense Health Agency of these Web sites or the
information, products or services contained therein. For other than
authorized government activities. The Defense Health Agency does not
exercise any editorial control over the information you may find at other
locations. Such links are provided consistent with the stated purpose of
this DoD Web site. Accessibility/Section 508