OMB control number

Safety and Health Information Collection

OMB 0693-0080 · DOC/NIST.

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 renewal of approval of three health unit forms to be utilized for these individuals.

The latest form for Safety and Health Information Collection expires 2028-01-31 and is listed under ICR 202408-0693-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
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All Historical Document Collections

Historical document collections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

OMB Details

Audiological History

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form NIST-426	Audiological History	Paper Only	Form

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