Every entry in the Defense records system exists because some decision needed a documented basis, and DD Form 2215 is one of those instruments: DD Form 2215, Reference Audiogram, January 2000, created to Reference Audiogram. The reason it carries a DD number rather than a service designation is structural — the Department maintains a single body of forms for matters that arise identically in every service, so that a record created in one component remains intelligible in another.
The practical effect of Department-level issue is interoperability. not stated establishes the requirement across the Defense enterprise; not stated keeps the document current for all of it. No service maintains its own variant, which means a completed record travels between components — service to agency, agency to joint command — and arrives in a format the receiving office already knows how to read.
You are looking for edition not stated, listed as not stated. Department-wide supersession is a single event rather than a rollout, which is what distinguishes edition currency on a DD form from the same question on a service publication: nobody anywhere is still accepting the previous version out of habit.
The form is laid out top to bottom in a sequence that reflects how the record will be read, not merely how it was drawn. Identification comes first because everything below it is understood in relation to a named person, unit or transaction; substantive entries follow; certification closes the document because certification attests to what precedes it. Filling out of order tends to produce internal inconsistencies — an entry that made sense before the header was settled and does not afterward.
Before the first entry, compare the date printed on the form face with not stated. This is not bureaucratic fussiness. Editions change field numbering, and a receiving office working from the current layout may look for information where your copy does not put it. On a Department form the exposure is wider than usual: your record may be reviewed by an office in another service entirely, one with no reason to remember what the previous edition looked like.
Leave nothing empty. Where an item genuinely does not apply, N/A is the correct entry, because the record must distinguish between a question that was answered in the negative and a question that was never reached. An empty box carries no information about which happened. Date fields deserve particular care on a Department form, since the reviewer may write dates by a convention different from yours; use the format the form itself specifies.
Understand what the Privacy Act Statement is doing on the page. It exists because collecting personal data from an individual triggers a duty to explain the collection: under what authority, for what purpose, to whom the information may routinely go, and whether you are obliged to answer. That explanation precedes the fields for the obvious reason — afterwards it is merely a notice, beforehand it is a basis for deciding.
Signature is the point at which a completed form becomes a certification, and the requirement follows from that. On paper it means ink in the designated block; electronically it means a credentialed digital signature, ordinarily applied with a Common Access Card in software that supports it. A name typed into the signature field is data, not an act — it demonstrates nothing about who entered it. The date beside the signature fixes when the certification was made, which is why a signed but undated block is treated as incomplete.
The defects that return forms are the same ones year after year: a superseded edition, required fields left blank, handwriting that fails on reproduction, dates in a convention the form did not ask for, and certification without a signature or without a date. Where a specific field is genuinely unclear, the instructions printed on the form come first and not stated governs where the two do not agree.
Download the form
Formats available: PDF, across 2 pages and about 50 fields. That several formats coexist is a consequence of scale — the Department cannot standardize the software on every desk that needs this form, so it standardizes the document instead.
The difference between a fillable and a printable pdf is a difference in what the file contains. A fillable release carries an interactive layer: each box is a defined field with a name and a data type, and what you type is stored as data inside the document. A printable release has no such layer — it is an image of the page, and the only place your answers can go is onto paper. The distinction matters downstream, because a Department record often gets scanned and forwarded several times before it reaches its final file, and typed characters survive that chain in a way pen strokes do not.
If you find an xfdl file here, its presence is historical. The format belongs to IBM Lotus Forms, which the Department adopted Department-wide for electronic forms and fielded on a scale that makes wholesale removal slow. You need the matching viewer to open it; ordinary pdf software cannot read the format and will say so unhelpfully.
Every format is free, as published government documents are. A note on tools, though — the interactive field layer that makes a fillable pdf useful is precisely the part browser viewers handle least reliably. Save the file, open it in a full pdf reader, and the fields behave as the form's designer intended.
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
Submission follows not stated and whatever local instruction supplements it. Make a copy before the original leaves. Department forms travel across organizational lines by design, and the administrative distance that makes them useful is the same distance that makes tracing a lost one difficult.
Forms referenced inside this one are located by number alone, and that simplicity is a direct product of Department-level numbering. Because the DD sequence is maintained centrally and not duplicated by service, a number is a complete address: one number, one document, throughout the Defense establishment.
Procedures that touch both Department and service processes will cite forms from both sequences, and the coincidence of numbers between them is exactly that — coincidence. An Army proponent maintains the DA series for the Army; not stated or another Department office maintains the DD series for the whole Department. Two independent registries, two independent numbering runs, no correspondence at any value.
A form is downstream of the policy that requires it, and revision usually starts there: a directive is reissued, a collection requirement is altered, notice language is updated by statute. The form is republished as a consequence. Since none of that reaches individual users, an archived copy quietly becomes wrong, and verifying not stated each time you download is the whole remedy.
What you have here is the document and a description of it, which is a different thing from guidance. This page is not an organ of the Department, gives no legal or procedural advice, and makes no representation about the outcome of any filing; the offices that administer the requirement are the only ones positioned to answer that. Applicability, eligibility and procedural questions belong to not stated, to your servicing personnel office, or to the office designated 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?