Ergonomics Plus - Office Ergonomics Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date
• Add location
  Address

Seating

• Is your chair vertically adjustable and on a five-point base?

  Yes

  No

  N/A

• Does your chair have an adjustable lumbar (low back) support?

  Yes

  No

  N/A

• Does your backrest provide adequate support for your back?

  Yes

  No

  N/A

• Does your seat pan width and depth provide for good fit and comfort?

  Yes

  No

  N/A

• Does the seat pan cushion provide adequate comfort for you?

  Yes

  No

  N/A

• Does your seat pan have tilt adjustability?

  Yes

  No

  N/A

• Does the seat pan have depth (forward and backward) adjustability?

  Yes

  No

  N/A

• Does the seat pan have a rounded front that does not pressure the back of your knees and legs?

  Yes

  No

  N/A

• When seated, are your knees at or below the level of your hips (knees not higher than hips)?

  Yes

  No

  N/A

• Do your feet rest flat on floor or are they supported by a stable footrest?

  Yes

  No

  N/A

• Does your chair have armrests that support your forearms and do not interfere with swivel or normal movements of the chair?

  Yes

  No

  N/A

Keyboard & Mouse

• Does your keyboard location allow you to keep your upper arms and elbows close to the body (arms not extended outward beyond 45 degrees)?

  Yes

  No

  N/A

• Is there weight bearing support for your arms (chair arms or wrist rest) when you are using your keyboard?

  Yes

  No

  N/A

• Does the keyboard position and angle allow for a neutral wrist posture so hands are in a straight line with forearms (not bent up/down or sideways toward little finger)?

  Yes

  No

  N/A

• Does the mouse location allow you to keep your upper arm and elbow close to body (arm not extended outward beyond 45 degrees)?

  Yes

  No

  N/A

• Is there weight bearing support for your arm (chair arm or wrist rest) when you are using your mouse?

  Yes

  No

  N/A

• Does the placement of the mouse allow for a neutral wrist posture so your hand is in a straight line with forearm (not bent up/down or sideways toward little finger)?

  Yes

  No

  N/A

• Do your arms and wrists rest upon surface areas (arm rests, wrist rests, desktop) absent from any sharp or hard edges?

  Yes

  No

  N/A

Monitor

• Is the screen directly in front of you (no twisting of your head and neck)?

  Yes

  No

  N/A

• Is the top line of screen at or slightly (0-30 degrees) below eye level?

  Yes

  No

  N/A

• Is the monitor located at least arm's length away from you?

  Yes

  No

  N/A

• Can you clearly read the screen without bending head, neck or trunk forward/backward?

  Yes

  No

  N/A

• Is the monitor in a location that eliminates glare on the screen which might cause you to assume an awkward position to read screen? (Answer "no" if there is any glare on your screen)

  Yes

  No

  N/A

• Is the screen placed at right angles away from windows and task lights to avoid glare and bright light directly behind the screen?

  Yes

  No

  N/A

Other

• Is there adequate desktop space available to perform job tasks without twisting, side vending, or reaching?

  Yes

  No

  N/A

• Is there enough clearance for your feet, knees, and legs?

  Yes

  No

  N/A

• Is there adequate space that allows you to swivel your chair (without leg obstruction) to perform work tasks?

  Yes

  No

  N/A

• If your job requires frequent telephone use, is a headset provided to use when phone communication is combined with hand tasks such as typing and writing?

  Yes

  No

  N/A

• If your job requires frequent viewing of documents, is a document holder provided to hold documents in a vertical position?

  Yes

  No

  N/A

• Is the document holder (if provided) placed at about the same height and distance as monitor screen?

  Yes

  No

  N/A

• Add signature

  Sign