Devices, Tools or Related Information Concept Submission Form

The Concept Submission Program process is designed to collect information on evidence-based services, products, programs and research that support service members and their families and is available to the general public. The information that a collaborator shares about products or services must be related to psychological health and/or traumatic brain injury.

By completing the submission form, you are agreeing to have your submission reviewed by a representative of the Psychological Health Center of Excellence (PHCoE) or the Defense and Veterans Brain Injury Center (DVBIC) who may wish to contact you for further information related to your submission.

DHA does not award contracts, provide research grants or offer other forms of financial support.

DHA does not purchase programs, services or products through the concept submission process.

If you are seeking funding, please visit: http://www.usamraa.army.mil/Pages/fundingOpp.aspx.

For grant announcements, please visit: www.grants.gov.

For additional information, please visit the TRICARE Management Activity Acquisitions website: http://tricare.mil/tma/ams/

CAUTION: This is not a secure or protected message system. Please do not provide sensitive personal information such as your social security number or medical condition.

Contact Information

(10,000 character limit)
If applicable.

Topic Areas

Check 4 most closely associated

Population(s) that would benefit from this information

Check 4 most closely associated
What do you hope to gain as a result of this concept submission? e.g. “Request dissemination of information about this device/tool throughout DoD” or “Request DHA be aware of our device that shows improved outcomes for PTSD/TBI” (10,000 character limit)
e.g. What does the device do? What were the results? (10,000 character limit)
e.g. What is used? How is it used? How long is the device/tool used? etc. (10,000 character limit)
e.g. “This device assists active duty Service Members post-deployment” or “This device/tool is for inpatient treatment of adolescent military family members ages 12-18 with mood disorders” (10,000 character limit)
e.g. Has device been used in populations? Where/When/Outcomes, contact information of location and/or points of contact? (10,000 character limit)
e.g. What populations are not recommended to use this device/tool? What are the limitations of the device? (10,000 character limit)
i.e. insurers who have approved (10,000 character limit)
e.g. “We will be presenting this device at _____” or “We are refining/expanding our device to _____” or “We have applied for a grant with _______.” (10,000 character limit)
(10,000 character limit)

Evidence to Support Device

Please list supporting empirical evidence for use of the device. If anecdotal evidence please list as such.
Citation or short paragraph for each or Not Available (10,000 character limit)
Citation or short paragraph or N/A (10,000 character limit)

CAUTION: This is not a secure or protected message system. Please do not provide sensitive personal information such as your social security number or medical condition.

By completing the submission form, you are agreeing to have your submission reviewed by a representative of DHA who may wish to contact you for further information related to your submission.

DHA does not award contracts, provide research grants or offer other forms of financial support.

DHA does not purchase programs, services or products through the concept submission process.

If you are seeking funding, please visit: http://www.usamraa.army.mil/Pages/fundingOpp.aspx.

For grant announcements, please visit: www.grants.gov.

For additional information, please visit the TRICARE Management Activity Acquisitions website: http://tricare.mil/tma/ams/