DD Form 3043-1 - also known as the "Tricare Select Enrollment, Disenrollment, And Change Form (east)" - is a United States Military form issued by the Department of Defense.
The form - often incorrectly referred to as the DA form 3043-1 - was last revised on December 1, 2017. Download an up-to-date fillable PDF version of the DD 3043-1 below or request a copy through the chain of command.
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