Information
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Conducted on
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Name of assessor
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This risk assessment template is based around the HSE "working with display screen equipment (DSE): a brief guide" leaflet INDG 36 (revision 4) and the associated Display screen equipment (DSE) workstation checklist issued on 05/13
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Location
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Make and model?
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Quantity?
Furniture
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Is the chair in good condition i.e. no stains or rips
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Action to be taken
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Responsibility
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Overall Condition 1-5
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Can the chair be adjusted correctly?
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Action to be taken
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Responsibility
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Does chair have back adjustment and seat height adjustment
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Does chair have seat tilt
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Does chair have seat slide
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does chair have lumbar pump
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Action to be taken
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Responsibility
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Does chair have adjustable arm rests
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Action to be taken
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Responsibility
