Ergonomic assessment form 2026

1. Click ‘Get Form’ to open the ergonomic assessment form in the editor.
2. Begin by filling in the 'Date', 'Activity Assessed', 'Organization', and 'Point of Contact' fields at the top of the form. This information is crucial for tracking and accountability.
3. Next, assess the risk rating by circling either High, Medium, or Low based on your observations. Refer to the notes at the bottom of the form for guidance on determining this rating.
4. In the Ergonomic Assessment Checklist section, answer each question regarding risk factors by selecting 'Yes' or 'No'. Be thorough as these responses will inform necessary actions.
5. If you answered 'Yes' to any questions, use page two to provide a brief explanation of the activity or complaint associated with those risks.
6. Finally, complete the Ergonomic Survey Evaluation section by detailing any additional risks and providing your name as the assessor along with the date.

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