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Ergonomic Keyboard or Mouse Request - Free HR Template | ZenBuild | ZenBuild

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Ergonomic Keyboard or Mouse Request

Request an ergonomic keyboard, mouse, or wrist support to address discomfort or prevent injury.

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Ergonomic Keyboard or Mouse Request

Request an ergonomic keyboard, mouse, or wrist support to address discomfort or prevent injury.

Employee Name*

Work Email*

Department*

Work Location*

Equipment Requested*

Ergonomic KeyboardErgonomic MouseWrist RestTrackball MouseVertical Mouse

Health or Medical Need?*

YesNo

Describe the Discomfort or Issue*

Medical Note (if available)

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Template Details

CategoryHR

IndustryHuman Resources

Fields8

Uses0

Views0

ergonomicskeyboardmouseequipment