• Conducted on

  • Document No.

  • Prepared by

  • Plant

  • Location
  • Number of Workers

  • Job or Task

  • Shift

  • Department

  • Job Rotation

Section 1

Neck and/or Shoulder

  • High Force / Posture: Neck: Fully flexed or extended neck positions. Shoulders: Working above shoulder level or behind the body. Arms: Forceful push/pull exertions

  • Low Force / Posture: Neck: Slight bending of the neck (<5 degrees). Shoulder: Easy arms reaches in front of the body - elbows are close to the body. Arms: Low exertion or push/pull motions with shoulder and arms.

  • This job / task requires what type of force / posture?

  • High Frequency: Neck: Repetitive bending or twisting of the neck (>15 bends or motion per minute). Shoulder: Reaching above shoulder level or behind the body (<6 bends or motions per minute). Frequent push/pull motions.

  • Low Frequency: Neck: Occasional bending of the neck (2 or less per minute). Shoulder: Reaching a over shoulder level or behind the body (2 or less per minute). 1 or less push/pull motions per minute.

  • This job / task is performing these forces / postures at what frequency?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.