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 Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) who may wish to contact you for further information related to your submission.

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

DCoE 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/baa_forms/index.cfm.

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.

Device/Tool Concept Submission Form

Contact Information

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 DCoE be aware of our device that shows improved outcomes for PTSD/TBI”
e.g. What does the device do? What were the results?
e.g. What is used? How is it used? How long is the device/tool used? etc.
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”
e.g. Has device been used in populations? Where/When/Outcomes, contact information of location and/or points of contact?
e.g. What populations are not recommended to use this device/tool? What are the limitations of the device?
i.e. insurers who have approved
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 _______.”

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
Citation or short paragraph or N/A
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

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 DCoE who may wish to contact you for further information related to your submission.

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

DCoE 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/baa_forms/index.cfm.

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

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