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How to use or fill out the fillable ergonomic form
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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the designated fields, including your name, date, phone number, building/room number, department, job title, and departmental supervisor.
Indicate your average daily PC usage by selecting one of the options provided (0-2 hours, 2-4 hours, etc.).
Answer whether you experience CTD symptoms and if follow-up is needed. Provide a follow-up date if applicable.
Review the recommendations for correct sitting posture and check 'Yes' or 'No' for each statement based on your current setup.
Continue through sections on keyboards/hands, monitor positioning, copyholder use, phone usage, work habits, and general office recommendations. For each section, provide feedback by selecting 'Yes' or 'No' and adding any necessary comments.
Finally, ensure that the evaluation conducted by field is filled out with the evaluator's name and date before submitting.
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Ergonomic assessments are an objective study of how employees work. The assessments help identify the ergonomic risks such as repetitive tasks that can cause strains, improper work area setup, and improper use of tools, which can result in the development of work-related musculoskeletal disorders (MSDs).
What are the 5 components of ergonomics?
The Value of Using An Office Ergo Process 1. Discomfort Survey 2. Interview/Job Description 3. Physical Measurements 4. Postural Observations 5. Pictures 6. Adjustments 7. Final Report Thats It! Thats the 7-step process for doing effective office ergonomic assessments!
What 3 things does ergonomics measure?
The three main ergonomic risk factors for physical injuries in the workplace are: sustained poor posture. repetitive tasks. forceful exertion.
Is there an OSHA standard for ergonomics?
There are five aspects of ergonomics: safety, comfort, ease of use, productivity/performance, and aesthetics. Ergonomics is a science concerned with the fit between people and their work.
What is an ergonomic checklist?
Ergonomic workstation and workspace checklist (DOCX) a self-assessment tool to be conducted by the individual at their workstation and workspace. The goal of the checklist is to identify potential problem areas and to determine suitable amendments and recommendations that can be made.
CHAIRS WITH ADJUSTABLE HEIGHT This is an example of your chair being able to accommodate you ergonomically. You should raise your chair high enough to allow the soles of your feet to rest flat on the floor. Thighs should be parallel to the floor at a right angle so that the hips are level with the knees.
Related links
Workstation Ergonomics Self Assessment
All completed assessments should be submitted to your DOHS ergonomics specialist. Person Completing Assessment. Name. Position. Signature. Date. DOHS Ergonomics
Fillable Base: Hollow base can be filled with water or sand for more stable application. C-Hook: Large C-Hook holds chain in place. Use open, or closed
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