Free Workplace Ergonomic Risk Identification Form

Uncover the ultimate solution for identifying and mitigating workplace ergonomic risks with Template.net's Workplace Ergonomic Risk Identification Form Template. Completely editable and customizable using our intuitive Ai Editor Tool, this template empowers you to assess and address ergonomic concerns effectively. Simplify risk management and enhance workplace safety with Template.net's innovative resources.

Name:	[Your Name]
Department:
Job Title:
Email:
Contact Number:

Workstation Setup
Type of Workstation:	Desk
Chair Type:
Computer Monitor(s):
Keyboard and Mouse:
Workspace Layout
Arrangement of Equipment:	Dual monitors side by side, keyboard and mouse centered
Space Utilization:

Chair Assessment
Chair Height:	Adjustable
Back Support:
Armrests:
Desk and Monitor Assessment
Desk Height:	Adjustable
Monitor Height:
Document Holder:

Breaks and Movement
Break Schedule:	5-minute break every hour
Microbreaks
Stretching Exercises:
Keyboard and Mouse Usage
Typing Posture:	Wrists straight
Mouse Placement:

Physical Discomfort
Reported Discomfort:	Occasional neck pain
Affected Body Parts:
Risk Level Assessment
Overall Risk Level:	Medium
Specific Risks:

Free Workplace Ergonomic Risk Identification Form

Employee Details

Workstation Information

Ergonomic Equipment and Accessories

Employee Habits and Work Practices

Ergonomic Risk Assessment

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