Office ergonomics workstation assessment

Template

The Office Ergonomics Workstation Assessment Template will help determine whether the workstation is a good fit for the employee. It will provide basic questions and tips to set up and maintain a healthy workspace in the office.

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Template structure

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  • 1. Name

  • 2. Department

  • 3. Email

  • 4. Phone

  • 5. Date

Backlog

  • 1. Auditor

Workspace

  • 1. Does the work surface height allow you to position your upper body (shoulders, arms, and hands) in neutral position to use keyboard, mouse, pens, etc.?

    • Yes
    • No
  • 2. Is there enough space for legs/feet under the work surface?

    • Yes
    • No
  • 3. Are frequently used items within easy reach of a seated user?

    • Yes
    • No
  • 4. Is there adequate storage space for your files, supplies, reference materials, and personal items?

    • Yes
    • No
  • 5. Is the workspace easily adjustable?

    • Yes
    • No
  • 6. Action plan

Chair

  • 1. Are chair casters suitable for the floor type?

    • Yes
    • No
  • 2. Is the seat pan height adjustable?

    • Yes
    • No
  • 3. Does the seat support the user's body weight and size?

    • Yes
    • No
  • 4. Is the seat tension properly set for the user's body weight?

    • Yes
    • No
  • 5. Is there a 2 to 3-inch gap between the seat pan and the back of the user's knees?

    • Yes
    • No
  • 6. Does the seat pan have a waterfall front design?

    • Yes
    • No
  • 7. Is the seat back adjusted to support the spine in neutral posture?

    • Yes
    • No
  • 8. Do armrests provide forearm support?

    • Yes
    • No
  • 9. Is the chair functioning properly (no maintenance problems)?

    • Yes
    • No
  • 10. Action plan

Computer

  • 1. Is the monitor positioned directly in front of the user?

    • Yes
    • No
  • 2. Is the monitor height (top of screen) at or slightly lower than eye level?

    • Yes
    • No
  • 3. Is the monitor distant enough to allow optimal clarity?

    • Yes
    • No
  • 4. Is the monitor free of glare?

    • Yes
    • No
  • 5. Are documents properly placed to allow neutral neck/head position?

    • Yes
    • No
  • 6. Does the keyboard allow neutral shoulder, arm, and hand position?

    • Yes
    • No
  • 7. Does the mouse allow neutral shoulder, arm, and hand position?

    • Yes
    • No
  • 8. Does the keyboard/mouse tray provide a stable platform within easy reach?

    • Yes
    • No
  • 9. Action plan

Office equipment

  • 1. Is the computer functioning properly (no maintenance problems)?

    • Yes
    • No
  • 2. Does telephone use allow neutral shoulder, head and neck position?

    • Yes
    • No
  • 3. Does other frequently used office equipment allow neutral body postures?

    • Yes
    • No
  • 4. Action plan

Work environment

  • 1. Is the workstation lighting suitable for the work being performed?

    • Yes
    • No
  • 2. Are noise levels conducive for the workspace?

    • Yes
    • No
  • 3. Is the workstation temperature comfortable enough for the work being performed?

    • Yes
    • No
  • 4. Action plan

Done

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