Safety and Health Information Collection

OMB 0693-0080

The National Institute of Standards and Technology (NIST) is a unique federal campus which hosts daily a range of non-federal individuals. Non-federal individuals may include NIST Associates, volunteers, students, and visitors. In order to provide these individuals with proper care and health documentation, NIST is pursuing approval of three health unit forms to be utilized for these individuals.

The latest form for Safety and Health Information Collection expires 2021-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form NIST-986 Health Record Form
Form NIST-985 Injury / Illness / Exposure Assessment Form
Form NIST-426 Audiological History Form
PRIVACY ACT STATEMENT.docx Supplementary Document
0693-0080 OSHE Supporting Statement_2024.docx Supporting Statement A
SORN COMMERCE DEPT.18.pdf Supplementary Document
Health Record Form
Injury / Illness / Exposure Assessment Form
Audiological History Form

All Historical Document Collections

202408-0693-002	Extension without change of a currently approved collection	2024-08-28
202207-0693-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-07-14
202107-0693-003 Approved without change	Extension without change of a currently approved collection	2021-07-27
201805-0693-001 Approved without change	New collection (Request for a new OMB Control Number)	2018-05-29

OMB Details

Audiological History

Federal Enterprise Architecture: Health - Health Care Services

Form NIST-426

Audiological History

Paper Only

Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.