What is DD Form 2215? It is a Department of Defense form titled DD Form 2215, Reference Audiogram, January 2000, and its job is straightforward: Reference Audiogram. That single line covers most of what people want to know before they download it.
Does it apply to your branch? Yes. The DD prefix means Department of Defense, not one service, so the same blank serves the Army, Navy, Air Force, Marine Corps, Space Force and the Coast Guard under Defense jurisdiction. There is no Army version and no Navy version to search for.
Who is behind it? not stated maintains the form, and not stated is the publication that requires it. Those two names answer most questions about why you are being asked to submit anything at all.
How current is this? Edition not stated, publisher status not stated. That is the version described throughout this page.
What the form asks for
- Press this reset button to clear the data from all fields
- 1. Zip code, A. P. O., F. P. O., P. A. S.
- 2. D. O. D. component. Enter A. for army, F. for air force, N. for navy, M. for marine corps
- 3. Service component. Enter R for Regular, V for Reserve, G for National Guard, or 1 for other.
- 4. Social security number. Do not include dashes.
- 5. Name (last, first, middle initial).
- 6. Date of birth. (4 digit year, 2 digit month, 2 digit day)
- 7. Sex. Enter M if male, F if female.
- 8. Pay grade, uniformed services.
- 9. Pay grade, civilian.
- 10. Service duty occupation code.
- 11. Mailing address of assignment.
- 12. Location - place of work.
- 13. Major command.
- 14. Duty telephone (include area code).
- Audiometry Section. Item 15. Reason for conducting audiogram. Enter number in box for reason to complete reference audiogram. Enter 1 for individual has not yet worked in hazardous noise duty areas, and no reference audiogram has been accomplished. Enter 2 for individual has worked in hazardous noise duty areas but reference audiogram has been lost or was never accomplished. Enter 3 for individual has worked in hazardous noise duty areas and requires revised reference audiogram following completion of hearing conservation follow up program.
- 17. Date of audiogram (4 digit year, 2 digit month, 2 digit day).
- 16. Audiometric data. Left, 500.
- Left, 1000
- Left, 3000
- Left, 4000
- Left, 6000
- Left, 2000
- Right, 500
Download the form
Which files are here? These: PDF. How much work is involved? 2 pages, about 50 entry fields.
What is the difference between fillable and printable? A fillable pdf has real field boxes that accept typed text and hold it inside the file. A printable pdf is a flat blank with no fields at all, intended for a printer and a pen. Which one you have determines how you complete the form, so it is worth checking first.
Should you type or write? Type, whenever the choice is yours. The reason is what happens after submission: the record gets copied and scanned, and every pass costs handwriting legibility that typed entries never lose.
Can you skip around the form? Better not to. The layout runs identification, then content, then certification, and entries near the bottom frequently take their meaning from what sits above them.
What if your copy is old? Replace it. Check the date printed on the form against not stated. Old blanks circulate for years in shared folders, and because a DD revision lands across the whole Department at once, the receiving office will be working from the new layout.
Can you leave fields blank? Not safely. A reviewer cannot tell a deliberate omission from a missed question, so mark inapplicable items N/A. And date fields? Match the format shown on the form — conventions differ, and misreading a date is easy.
What is the Privacy Act Statement doing on the form? Telling you, before you supply personal identifiers, under what authority the information is collected, what it will be used for, who else may see it, and whether answering is voluntary or mandatory. Is it worth reading? It is the only part of the form written for your benefit rather than the file's.
Is a typed name enough? No. The signature block takes an actual signature: pen on paper, or a digital signature applied with your Common Access Card where the receiving system accepts one. Add the date beside it before you close the file.
Which mistakes are worth a final check? Superseded edition, gaps in mandatory fields, unreadable writing on a scanned copy, non-conforming date format, unsigned or undated certification.
Is the form its own instruction manual? Partly. The rest sits in not stated, which is also the authority where the two texts conflict.
What happens after you finish? It routes to the office specified in not stated or in local guidance. And your own record? Save a duplicate first; nobody regrets having one.
What if DD Form 2215 points to another form? Search the series and number. Because the DD sequence is common to every military department, no branch qualifier is needed to land on the right file.
Do DA and DD numbers ever correspond? Never. DA numbering is Army-specific, administered by an Army proponent, while DD numbering is Department-wide under not stated or an equivalent Department office. Identical digits in the two systems mean two unrelated documents, which is why the prefix matters more than the number.
Should you archive this file and reuse it next year? Better not. Forms are revised as directives are reissued, as data requirements shift and as statutory notice text is updated, and none of that reaches you directly. Download fresh, check the edition date.
Will your completed form be accepted? That is not a question this page can answer. What you have here is a published Department of Defense document, a description of it and instructions for filling it out. Nothing on the page is legal advice, and nothing here determines what any office does with a submission. Where do the remaining questions go? To not stated, to your servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2215?
- DD Form 2215, Reference Audiogram, January 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?