Every entry in the Defense records system exists because some decision needed a documented basis, and DD Form 2216 is one of those instruments: DD Form 2216, Hearing Conservation Data, January 2000, created to Hearing Conservation Data. 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.
That decision has consequences you will notice. Because not stated prescribes the form for the Department as a whole, and not stated maintains it on the Department's behalf, the same blank passes between the Army, the Navy, the Air Force, the Marine Corps, the Space Force, the Coast Guard when operating under Defense jurisdiction, the defense agencies and the combatant commands without translation. A clerk in one component reads a record created in another and finds the fields where they expect them.
The edition in force is not stated, carried by the publisher as not stated, and edition discipline is stricter on a Department form than most people expect, precisely because supersession happens everywhere at once. There is no interval during which one service still works from the previous layout while another has moved on.
The sequence printed on the form is the sequence in which a reviewer will read it, and the two should agree. Header data frames every entry below it; the substantive fields depend on that frame; the certification stands at the end because its whole function is to vouch for what came before. Entries made out of sequence commonly contradict entries made earlier.
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.
Every field takes an entry, N/A included. The reason is evidentiary rather than clerical: a completed record is supposed to show what was asked and what was answered, and blank space records neither. On dates, follow the format printed beside the field. Conventions vary between components, and a joint document is read by people who do not share your habits.
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.
Recurring defects have a pattern to them, and it is mostly the pattern of a record that cannot be relied on: an edition that does not match, gaps that cannot be interpreted, entries that cannot be read after scanning, dates that could mean two things, and a certification nobody executed. For an ambiguous field, read the form's own instruction, then not stated, which controls.
Download the form
The set published here is PDF, covering 2 pages with roughly 153 fields. More than one format survives because the Department serves users under very different conditions, from a desk with current software to a location where a printer is the only reliable output.
Fillable and printable are not two presentations of one file but two different objects. One holds your entries as structured data within the document; the other is a static picture meant to meet a pen. Since a DD form frequently moves outside the organization that created it, the durability of the entry matters more here than on a record that stays in one drawer. Typed text reproduces indefinitely; handwriting degrades at every copy.
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
- 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, or 1 for other DoD activity.
- 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).
- 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).
- 15. Audiometry. a. Purpose. Enter 1 if 90-day, 2 if Annual, 3 if Termination, or 4 if Other.
- 6. Date of birth. (4 digit year, 2 digit month, 2 digit day)
- f. Remarks. Include exposure data.
- g. Type of personal hearing protection used. Enter 1 for single flange (V. S. 1. R), 2 if triple flange, 3 if hand formed earplug, 4 if ear canal caps, 5 if noise muffs, or 6 if other.
- b. Current audiogram date. (4 digit year, 2 digit month, 2 digit day)
- Audiometric data. Left, 500.
- Left, 1000
- Left, 2000
- Left, 3000
- Left, 4000
- Left, 6000
Route the executed form as not stated or local guidance directs, and retain a duplicate first. Cross-component routing is ordinary for DD forms, which is precisely why a personal copy earns its keep: the receiving office may belong to an organization you have no standing to query about a missing document.
Cross-referenced documents are found by series and number, with nothing further required. That the DD sequence is unified across the Department means a cited number identifies one form and no other, which is the practical payoff of centralizing the numbering in the first place.
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.
Understanding why editions change explains why checking them is not optional. Revision follows directive reissue, changes in what data is required, and amendments to mandatory notice text — decisions made at Department level and communicated through publication rather than notification. The file you saved does not update itself, so the edition date at download is what you rely on.
A word on what this page is. It distributes a published Department of Defense document and describes what the document contains and how it is completed. It is not the issuing authority, does not speak for one, and offers no legal advice; nothing written here determines whether a particular submission will be accepted, because that determination belongs entirely to the office receiving it. Questions of applicability, eligibility or procedure go to not stated, to your servicing personnel office, or to the office identified in not stated.
Questions and answers
- What is DD Form 2216?
- DD Form 2216, Hearing Conservation Data, 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?