Ergonomics Self Assessment Form

 

 

The following assessment is to be used to ensure workstations are ergonomically designed. A “NO” answer to any of the following questions identifies an issue that may contribute to an ergonomic risk. 

 

CHAIR

YES

NO

N/A

Is your office chair supportive and comfortable throughout the day?

 

 

 

Can you adjust your chair so the lumbar support fits snugly in the small of your back so that you feel comfortable and supported without any pressure points?

 

 

 

When chair height is adjusted appropriately, your elbows are in line with your keyboard.

 

 

 

If your feet are not positioned on the ground, a foot rest is required.

 

 

 

Set aback angle is adjusted so user is in an upright position when using the keyboard.

 

 

 

KEYBOARD

YES

NO

N/A

Directly in front of you?

 

 

 

Placed so your upper arms are close to your body?

 

 

 

Can you maintain a natural and straight posture to your hands, wrists and forearms?

 

 

 

Separate keyboard, monitor and mouse is used, if using laptop for extended periods of time?

 

 

 

MOUSE

YES

NO

N/A

Can the mouse be places close to you and within your optimum reach zone?

 

 

 

Is it placed just beside the keyboard and at the same height?

 

 

 

Can you place your finger, wrists and forearms all in a straight line whiles using the mouse?

 

 

 

MONITOR

YES

NO

N/A

Is the monitor far enough away, i.e. you do feel the monitor is to close (generally no further than arm’s length away, 500-750 mm).

 

 

 

Are you able to look straight ahead at the monitor without twisting?

 

 

 

Is the top of your monitor at eye height?

 

 

 

Can the position and contrast of the screen be adjusted?

 

 

 

 

Need an appointment to relieve neck pain and headaches? 

 

Use the booking link below to schedule an appointment: