Free Workstation Assessment Form Template

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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