Workstation Assessment Form

WORKSTATION ASSESSMENT FORM

Employee Details

Name: 

[Your Name]

Employee ID: 

Department:

Date of Assessment: 

Workstation Overview

A. Workstation Configuration

Provide details about the employee's workstation configuration.

Component

Details

Operating System:

Intel 7i 4th Generation

Processor:

RAM:

Storage:

Monitor(s):

Graphics Card:

Other Peripherals:

B. Software Installed

List all software installed on the workstation.

Software

Version

Microsoft Office

2020

Ergonomic Assessment

A. Desk and Chair

Evaluate the ergonomic setup of the desk and chair.

Aspect

Assessment

Desk Height:

Comfortable and Adjustable

Chair Comfort:

Monitor Placement:

Keyboard Position:

Mouse Placement:

B. Lighting

Assess the lighting conditions around the workstation.

Aspect

Assessment

Natural Light:

Adequate

Artificial Light:

Glare on Monitor:

Health and Safety

A. Electrical Safety

Ensure the safety of electrical connections.

Aspect

Assessment

Power Strip Usage:

Properly Used

Cable Management:

Fire Hazards:

B. Comfort Breaks

Encourage the employee to take regular breaks.

Aspect

Assessment

Break Frequency:

Encourage Regular Breaks

Stretching Exercises:

Additional Comments

Provide any additional comments or recommendations.





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