Workplace Ergonomics Audit Form
WORKPLACE ERGONOMICS AUDIT FORM
Department/Location: Headquarters
Audit Date: [Month Day Year]
Date of Previous Audit (if applicable): 2052-12-15
Instructions:
Please provide accurate information to improve the well-being of your employees. Your input is vital for creating a safe and comfortable work environment. Thank you for your cooperation.
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Seating |
Yes |
No |
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Is the chair provided adjustable for height, backrest, and armrests? |
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Are employees provided with footrests if needed? |
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Computer Equipment |
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Is the computer monitor at eye level and directly in front of the employee? |
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Is the keyboard and mouse positioned to allow a natural wrist position? |
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Are glare-reducing measures in place to prevent eye strain? |
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Workspace Layout |
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Is there adequate lighting in the workspace? |
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Are there any tripping hazards, clutter, or obstructions in the workspace? |
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Is there sufficient space for employee movement and adjustments? |
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Ergonomic Training |
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Have employees received ergonomic training? |
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Is information on proper ergonomics available to employees? |
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Employee Feedback |
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Have employees reported discomfort or pain related to their workstation? |
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If yes, were actions taken to address their concerns? |
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Recommendations and Action Plan |
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List any recommendations or actions needed to improve ergonomics in the workplace: __________________________________________________________________________________ __________________________________________________________________________________ |
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Date for Follow-up Audit: [Month Day Year] Audit Conducted By: [Your Name] ________________ |
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