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Enjoy this free ergonomic evaluation form courtesy of Get Up Stand Up Desk Co., your online source for the best ergonomic office furniture at the best prices. We hope that this evaluation will help you to identify ways to improve your posture and eliminate the every day aches and pains of sedentary computer work. If you find yourself wishing you had office furniture that helped you to be more active and promoted ergonomics in your work space give us a call at 1.888.339.4440 or email us at info@getupstandupdeskco.com. Did you know we offer from work space design consultations? You give us your vision and we can help you make it happen. Contact us for pricing on high volume orders.

Computer Workstation Ergonomic Evaluation Report Name: Date: Ministry: Job title: Location: Workstation location: Supervisor: Evaluated by: Primary job activities: Current musculoskeletal concerns:

CHAIR (Sitting fully back into the chair) Seat height Back rest height Seat pan depth Tilt Armrest position Adjusted so feet are flat on floor or footrest with knees bent at right angles and thighs horizontal to floor. Lumbar support of chair is at correct height to support the lumbar curve There is about 2-4 finger widths between front edge of the seat and back on the knees Seat is tilted so that hips and tops of thighs are at right angles or slightly greater Armrests are out of the way while typing but provide support when needed during other activities KEYBOARD AND MOUSE (should be at the same height) Elbows are at 90 to 110 degrees and Keyboard/mouse forearms and hands form straight lines height to the keyboard Mouse height Mouse is adjusted so it is close to and on the same level as the keyboard Keyboard to user Mouse to user Hand posture on mouse Speed of the mouse Distance allows user to relax shoulders with elbows hanging close to body Mouse is directly next to the keyboard and at the same height so arm is not outstretched while mousing Base of the hand rests on the mouse. Use larger mouse or mouse mate if necessary Mouse is configured to match individual needs (control panel Keyboard tray and mouse stage Adjusted to allow neutral posture and minimal reaches and ease of use

MONITOR Monitor height Screen to user Monitor alignment Visual comfort of screen Brightness and contrast controls Top of screen is at or slightly lower than eye level so that users head is straight. With bifocal/graduated lenses, height is set to allow straight head and relaxed neck Viewing generally 18 33. Depending on vision, user is not jutting chin or pushing head forward or squinting to see clearly Monitor and keyboard are directly in front of user. Monitor is positioned to avoid glare. Usually perpendicular to bright sources or outdoor blinds Brightness and contrast have been adjusted to make viewing easier WORK ENVIRONMENT AND WORK SURFACE There is 2 side clearance for hips, Leg clearance at depth allows foot and knee clearance, workstation height is adequate Placement of frequently used items Document placement General lighting Frequently used items are within easy reach Document holder is present or there is space to place documents properly Lighting is not too bright or dim, glare and reflections are minimal and work materials are easy to read WORK PRACTICES Frequency of breaks Micro-break every 30 min of keyboarding. Get out of chair at least once per hour Alternate tasks Keyboarding/ mousing posture Sitting posture Phoning posture Reach posture Long periods of continuous use are broken up with alternate tasks Wrists are straight, not supported on any surface while typing. Rest occasionally when not typing on sides of hands. Upright or slightly reclined and maintaining a slight curve in lower back Avoid tilting head/neck to cradle the phone. Uses headset if necessary. Position phone set on opposite side of writing hand. Stand to get items from overhead shelves. Avoid repetitive reaching over shoulder level

Computer Workstation Ergonomic Evaluation Checklist (Cont d) Notes: 1. Ergonomic risk factors were discussed and the worker is very aware of potential ergonomic risk factors and how to prevent musculoskeletal injury and how to work in a safe and healthy manner. 2. Worker has adequate ergonomic equipment in working condition and is aware of how to make ergonomic adjustments to the equipment, as necessary, to achieve and maintain appropriate ergonomic positioning while working. Observations and Recommendations: 1. 2. 3. 4. 5. 6 7. 8, 9. 10, 11.