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Workplace Ergonomics Assessment - Free HR Template | ZenBuild | ZenBuild

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Workplace Ergonomics Assessment

Workplace ergonomics assessment form for evaluating employee workstation setup, identifying discomfort, and recommending adjustments. Helps employers reduce injury risk and improve comfort.

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Workplace Ergonomics Assessment

Please complete this form to help us evaluate your workstation setup and identify any ergonomic improvements.

Employee Name*

Department*

Primary Work Location*

Average Hours at Desk Per Day*

Current Equipment (select all that apply)

External monitorExternal keyboardExternal mouseMonitor stand or armFootrestErgonomic chairWrist rest

Areas of Discomfort (select all that apply)

NeckShouldersUpper backLower backWrists / handsEyes / visionNone

Is your monitor at eye level when seated?*

YesNo, too highNo, too lowNot sure

Additional Comments or Equipment Requests

Template Details

CategoryHR

IndustryHuman Resources

Fields8

Uses0

Views2

hrergonomicsworkplace-safetywellness