Report • CampusOptics

Reporter Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Location

Name* Required

Additional Location Details

Exact Location

Loading…

Sitting

Employee Name* Required

Date of Assessment* Required

Overall description of your workstation setup and any concerns

You know how to operate your chair

Chair operation - Comments

Adequate back and lumbar support so the ears are in line with the shoulders and hips

Back and lumbar support - Comments

Shoulders relaxed and level when keyboarding and using the mouse

Shoulders relaxed and level - Comments

Elbows in line or slightly lower than the hands

Elbows position - Comments

Thighs parallel to floor, knee at same height as hips

Thighs parallel to floor - Comments

Two to three finger breadth between knee and front edge of seat pan

Knee and seat pan space - Comments

Adequate space on work surface – frequent reaches are in 2 o'clock or 10 o'clock positions with a bend in the elbow

Work surface space - Comments

Adequate space beneath work surface to move legs

Space beneath work surface - Comments

Minimal reaching above shoulder and below knee heights

Reaching above shoulder/below knee - Comments

Relaxed arm position during keyboarding with no direct pressure on the wrists

Relaxed arm position - Comments

Wrists in neutral/straight position while keyboarding (not up, down or to one side)

Wrists neutral position (keyboard) - Comments

Keyboard aligned with monitor and chair

Keyboard alignment - Comments

Wrists in neutral/straight position while using the mouse (not up, down or to one side)

Wrists neutral position (mouse) - Comments

Relaxed grip on the mouse

Relaxed grip on mouse - Comments

Standing

Standing in a neutral position

Standing in neutral position - Comments

Standing for long periods of time

Standing for long periods - Comments

Documents and equipment positioned appropriately while standing

Documents and equipment positioning (standing) - Comments

Keyboard

Mouse

Monitor and Documents

Head neutral posture especially no 'chin up' posture, even a little bit

Head neutral posture - Comments

Monitor font size adequate and distance is suited for the worker and the performed tasks

Monitor font size and distance - Comments

Glare and brightness are controlled

Glare and brightness - Comments

Document placement – depends on task performed

Document placement - Comments

Telephone

Neck and Head Centered During Phone Use

Neck and Head Centered During Phone Use - Comments

Phone Within Easy Reach

Phone Within Easy Reach - Comments

Job Variety

Frequent Visual Rest

Frequent Visual Rest - Comments

Regular Movement

Regular Movement - Comments

Alternate Task Schedule

Alternate Task Schedule - Comments

Additional Comments or Accommodations

Comments

Add Supporting Documents

Add files to upload as supporting documentation along with your incident.