AF Form 1672: Hearing Conservation Referral Guide & Download – The AF Form 1672, officially titled Hearing Conservation Diagnostic/Center Referral (AF IMT 1672, JUN 91), is a key document in the U.S. Air Force Hearing Conservation Program (HCP). It facilitates referrals for specialized diagnostic audiological evaluations when standard hearing tests indicate potential issues related to noise exposure.
This form supports the protection of active duty, reserve, National Guard, and civilian personnel from hazardous noise in high-risk environments such as flight lines, maintenance shops, firing ranges, and industrial areas. It ensures timely access to expert care from audiologists or ENT physicians at designated Hearing Conservation Diagnostic Centers (HCDC) or Hearing Conservation Centers (HCC).
Why AF Form 1672 Matters in the Air Force Hearing Conservation Program?
The Air Force HCP follows DoD Instruction 6055.12 (Hearing Conservation Program) and AFI 48-127 (Occupational Noise and Hearing Conservation). These regulations require monitoring, education, engineering controls, and personal protective equipment (PPE) to prevent noise-induced hearing loss (NIHL), which remains a significant readiness and quality-of-life issue.
A Significant Threshold Shift (STS) detected on routine or follow-up audiograms often triggers further action. After initial follow-up testing (including a 14-hour noise-free period or 40-hour noise-free audiogram), persistent shifts may require referral for comprehensive evaluation to:
- Determine if the shift is temporary (TTS) or permanent (PTS).
- Assess work-relatedness.
- Evaluate fitness for duty.
- Recommend accommodations, restrictions, or changes in noise exposure.
The AF Form 1672 streamlines this process by documenting the referral from the local Hearing Conservation Program Manager (HCPM) or provider to a specialized center. It ensures proper tracking in the Defense Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC) and integration with forms like:
- DD Form 2215 (Reference Audiogram)
- AF Form 1753 (Hearing Conservation Examination)
- AF Form 1671 (Detailed Hearing Conservation Data Follow-up)
When to Use AF Form 1672?
Refer personnel using this form when any of the following criteria are met (as indicated in the form’s reasons-for-referral section):
- A. Complaint of difficulty hearing or understanding spoken communication, auditory cues, or signals.
- B. Difficulty wearing standard hearing protection devices (HPDs) or communication equipment.
- C. Invalid or unreliable test results suggesting exaggerated hearing loss or non-organic issues.
- D. Permanent threshold shift shown on a 40-hour noise-free audiogram (NFA).
- E. Significant findings on detailed follow-up (DFU) hearing test.
- F. Other (with remarks).
Additional triggers include problem audiograms with atypical configurations, large inter-aural differences, or suspected medical conditions requiring otolaryngology input. Referrals help determine Hearing Profile (H-1 through H-4) status per medical standards and support decisions on continued noise-hazardous duties.
How to Complete AF Form 1672 (Block-by-Block Overview)?
The one-page form divides responsibilities clearly:
Referring Officer / Local Provider Section (Blocks 1–8):
- 1. TO: Destination HCDC/HCC base and location (with ZIP code).
- 2. FROM: Referring unit/base, PAS code, phone, and date.
- 3–5. Name and contact of referring officer, plus date.
- 6–7. Reasons for Referral: Check applicable boxes (A–F) and add remarks (e.g., noise exposure history, prior audiogram results, or HPD fit issues).
- 8. Remarks: Provide additional details, such as time-weighted average (TWA) noise exposure if needed for HPD effectiveness calculations.
Patient Identification (Lower Section):
- 18. Patient’s Name (Last, First, MI)
- 19. SSN
- 20. Pay Grade
- 21. Date of Birth
- 22. Status (1. Active, 2. Reserve, 3. National Guard, 4. Civilian, 5. Other)
- 23. Workplace Identifier
- 24. AFSC/CSDC (Air Force Specialty Code or Civilian occupational series)
Audiologist / ENT Physician Section (Blocks 9–17):
- 9. Recommendations/Dispositions/Results: Check A–F (e.g., Return to duty, re-fit HPDs, discontinue noise exposure, re-establish reference audiogram).
- 10. Were medical records available? (Yes/No)
- 12–17. Signatures, phone numbers, and evaluation dates for the audiologist and ENT physician (as applicable).
The form is typically completed in conjunction with DOEHRS-HC entries and filed in the member’s health record (e.g., with SF 600). Previous editions remain usable.
Download the Official AF Form 1672
Access the current official version directly from the U.S. Air Force e-Publishing site:
→ Download AF Form 1672 PDF: https://static.e-publishing.af.mil/production/1/af_sg/form/af1672/af1672.pdf
Always use the latest version from e-Publishing.af.mil for compliance. Local supplements or electronic workflows in AHLTA/CHCS or DOEHRS may apply.
Related Forms and Resources in the Air Force HCP
- DD Form 2215: Baseline/reference audiogram.
- AF Form 1753: Routine hearing conservation examination.
- AF Form 1671: Detailed follow-up data after STS.
- DoDI 6055.12: DoD-wide hearing conservation policy.
- AFI 48-127: Air Force-specific implementation, including HCDC/HCC referral criteria and authorized centers.
Hearing Conservation Program Managers (HCPMs) and Public Health teams should consult their Major Command (MAJCOM) guidance and the AF Surgeon General’s Audiology Consultant for regional HCDC locations and timelines.
Best Practices for Compliance and Readiness
- Timely Referrals — Complete medical referrals promptly after confirmed STS or other criteria to meet DoD access-to-care standards.
- Documentation — Include noise exposure history, HPD fit-testing results, and prior audiograms to help specialists assess causation and work-relatedness.
- Education — Reinforce hearing protection training; many referrals stem from improper HPD use or fit issues.
- Follow-Up — Track outcomes in DOEHRS-HC and update the member’s hearing profile and duty status (e.g., via AF Form 422 if needed).
- Civilian Personnel — The program applies equally to DoD civilians in noise-hazardous positions.
Protecting hearing preserves operational effectiveness, communication in high-noise environments, and long-term quality of life for service members and civilians alike.
Need help with AF Form 1672 or the Hearing Conservation Program? Contact your local Public Health or Occupational Health clinic, or the Hearing Conservation Program Manager at your installation. For policy questions, refer to official sources on e-Publishing and the Defense Health Agency.
This guide is for informational purposes and is based on publicly available U.S. Air Force and DoD publications as of 2026. Always verify the most current forms, instructions, and local procedures through official channels.