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TRICARE Publications Questionnaire

Page 1 - page 1 of 3
Did you find what you were looking for?
What were you looking for?
500 characters allowed
Page 2 - page 2 of 3
On a scale of one to ten, how likely are you to recommend this publication to someone else?
On a scale of one to ten, what is your overall satisfaction with the publication?
Page 3 - page 3 of 3
Where did you find this publication?
Please select all that apply.
Which best describes you?
Which plans are you using?
Please select all that apply.
Which region are you currently located in?
Which category includes your age?
What is your gender?
TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved. The public reporting burden for this collection of information, 0704-0553, is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

An official form of the United States government. Provided by Touchpoints
OMB Approval #0704-0553 · Expiration Date 05/31/2025