Self Assessment and Ergonomic Equipment Request Form - OHCOW 2026

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The document is a Self Assessment and Ergonomic Equipment Request Form for LUFA members at Laurentian University. It guides users through assessing their seated body posture, office deskchair, keyboard tray, and wrist rest to ensure ergonomic safety while working. Members can request ergonomic equipment by completing the form and submitting it to relevant authorities for review and approval.

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Begin with Part A – Self Assessment. Carefully evaluate your seated body posture while keyboarding, answering each question with 'YES' or 'NO'. Ensure you adjust your chair for optimal posture as described.
Next, assess your office deskchair by checking the relevant features. Mark 'YES' or 'NO' based on whether your chair meets ergonomic standards.
Proceed to evaluate the keyboard tray and wrist rest sections, ensuring all criteria are met for a comfortable typing experience.
In Part B – Equipment Request, check all items you wish to request. Fill in your personal details including name, office room number, extension, email, and department.
Finally, review the recommendations section in Part C before submitting the form via email to your Faculty Dean and other designated recipients.

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What is the 30/30 rule in ergonomics?

Set reminders to take breaks. Do you take regular eye breaks from looking at your monitor? Practice the 30:30:30 rule: refocus your eyesight every 30 minutes on something that is 30 feet away for 30 seconds.

Which type of questions should you ask when engaging in self-assessment?

Questions about strengths and weaknesses Self-evaluation questions like these encourage employees to consider the strengths and skills they can improve: What were your greatest strengths during the last evaluation period? What are the weaknesses you see in your work performance?

How long does an ergonomic assessment take?

An ergonomic assessment for an individual workstation takes approximately one hour to complete. The extent of the service depends on the employees request or level of pain. Employees who feel the need for an ergonomic assessment can request one from their manager.

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What should you ask yourself during a self-assessment in ergonomics?

Seat Height. Adjust seat height so that thighs are parallel to floor and feet are flat on the ground. Seat Depth. With your back resting on the backrest the thighs should overhang about 2 fingers widths. Lumbar Support. Armrest Height. Backrest.

What is the purpose of an ergonomic self-assessment?

The goal of this self-assessment is to help you set up your workstation for optimal comfort and performance. For more information, refer to the National Institutes of Health, Office of Research Services, Division of Occupational Health and Safety website.

What is the purpose of the ergonomic assessment?

The science of ergonomics aims to optimise the design of work to enhance safety, efficiency and comfort for the user. An ergonomic assessment of an office environment will encompass a review of the equipment used and its placement, the office environment and the individual.

What are the questions to ask for ergonomics?

Posture ▢Do you sit upright without slouching? ▢ Are your wrists in a neutral (straight) position when using the keyboard and mouse? ▢ If using a phone, do you avoid cradling it between your ear and shoulder? ▢ Do you change positions or adjust your posture throughout the day? ▢ Do you avoid crossing your legs while sitting?5 more rows Apr 16, 2025

Self Assessment and Ergonomic Equipment Request Form - OHCOW 2026

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