DD Form 2215. Reference Audiogram

DD Form 2215 - Reference Audiogram serves as a baseline hearing test result for individuals in the Department of Defense. It helps establish an individual's initial hearing capability for comparison with future audiograms to monitor any potential hearing loss.

The form includes sections for personal identification, such as name and social security number, as well as audiogram information. The audiogram section consists of frequency and hearing threshold level columns. There are separate columns for both the left and right ears.

Filling out DD Form 2215 involves accurate data entry of hearing thresholds at different frequencies. It's essential to ensure the correct unit of measurement is used for thresholds (dB HL). The form's accuracy is crucial for establishing a reliable baseline for future comparison.

Application Example: A new recruit entering military service undergoes a hearing test using DD Form 2215. This baseline audiogram is essential for tracking any changes in hearing ability over their military career.

No additional documents are typically required when completing DD Form 2215. There are no direct alternatives to this form within the Department of Defense for establishing a reference audiogram.