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This version of the form is not currently in use and is provided for reference only. Download this version of
DD Form 3043-2
for the current year.
DD Form 3043-2 TRICARE Select Enrollment, Disenrollment, and Change Form (West)
What Is DD Form 3043-2?
This is a form that was released by the U.S. Department of Defense (DoD) on September 1, 2021. The form, often mistakenly referred to as the DA Form 3043-2 , is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.
FAQ
Q: What is the DD Form 3043-2?
A: The DD Form 3043-2 is the TRICARE Select Enrollment, Disenrollment, and Change Form (West).
Q: What is TRICARE Select?
A: TRICARE Select is a health insurance program for military members and their families.
Q: What is the purpose of the DD Form 3043-2?
A: The DD Form 3043-2 is used to enroll, disenroll, or make changes to TRICARE Select coverage in the Western United States.
Q: Who can use the DD Form 3043-2?
A: Military members and their families in the Western United States can use the DD Form 3043-2.
Q: What information is required on the DD Form 3043-2?
A: The form requires personal information, such as name, address, and social security number, as well as details about the requested enrollment, disenrollment, or changes.
Form Details:
- A 4-page document available for download in PDF;
- The latest version available from the Executive Services Directorate;
- Editable, printable, and free to use;
- Fill out the form in our online filing application.
Download an up-to-date fillable DD Form 3043-2 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.
Download DD Form 3043-2 TRICARE Select Enrollment, Disenrollment, and Change Form (West)
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