Workplace Ergonomics Feedback Form
Workplace Ergonomics Feedback Form
Please take a few moments to complete this form. Your insights will help us identify areas of improvement and enhance the overall ergonomic experience for you and your colleagues.
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Employee Information |
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Name |
[Name] |
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Job Title |
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Department |
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Email Address |
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Phone Number |
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Ergonomics Feedback |
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Aspect of Ergonomics |
Very Satisfied (5) |
Satisfied (4) |
Neutral (3) |
Dissatisfied (2) |
Very Dissatisfied (1) |
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Chair and Seating |
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Desk and Workspace |
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Monitor and Display |
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Keyboard and Mouse |
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Lighting |
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Noise Level |
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Breaks and Posture |
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Workspace Layout |
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Comments/Suggestions |
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1 |
The workplace chair provides excellent lumbar support. |
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2 |
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3 |
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Thank you for taking the time to provide feedback. Your input is valuable in helping us enhance workplace ergonomics.
