Audiometry Health Surveillance

The Control of Noise at Work Regulations 2005

Introduction and Confidentiality Note

Dear Employee,

This hearing surveillance is required by your employer under the Control of Noise at Work Regulations 2005 due to workplace noise. Its purpose is to detect early the irreversible Noise-Induced Hearing Loss (NIHL) and to facilitate timely controls.

The assessment involves this questionnaire, an ear examination, and a hearing test. Your clinical results are medically confidential and will not be shared with your employer.

If a significant problem is detected, we will advise on a referral to an OH doctor or your GP as required by the Noise Regulations.

Your employer will only receive a hearing certificate with general advice. By completing this form and proceeding with the assessment, you consent to this process.