Free Workplace Ergonomics Review Form

Introducing Template.net's Workplace Ergonomics Review Form Template, an editable and customizable solution for assessing workplace comfort and safety. Utilize our AI Editor Tool to tailor forms to your organization's unique needs, streamlining the ergonomic review process. Enhance employee well-being and productivity with ease using this comprehensive tool.

REVIEWER INFORMATION
Reviewer Name	Mikey Goldberg
Professional Background	[Your Professional Background]
Contact Information	[Your Phone Number]
Date of Assessment	[MM/DD/YYYY]

EMPLOYEE INFORMATION
Employee Name	Jane Smith
Job Title	Project Manager
Department	Marketing

WORKSTATION SETUP
Aspect	Review
Chair Type	Ergonomic office chair
Chair Height	[Employee Chair Measurement]
Desk Type	[Employee Desk Type]
Desk Height	[Employee Desk Height]
Monitor Placement	[Angle and Distance from Monitor]
Keyboard and Mouse Position	[Alignment with Standards]
Lighting	[Workstation Lighting Condition]

EMPLOYEE ASSESSMENT
Aspect	Items	Assessment
Posture and Movement	Sitting/Standing Posture	Good sitting posture
Posture and Movement	Required Movements	[Comfort Description]
Health and Comfort Concerns	Existing Health Issue(s)	[List Health Issue(s) if any]
Health and Comfort Concerns	Specific Discomfort Areas	[Details of Discomfort]

RECOMMENDATIONS
Recommendation	Details
Workstation Adjustments	Adjust chair height, add lumbar support

Free Workplace Ergonomics Review Form

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